Great Lakes Dermatology
NPI 1558576322 · Procedural Dermatology Physician · Kenosha, WI
Great Lakes Dermatology is a Procedural Dermatology Physician organization in Kenosha, WI (NPI 1558576322).
Provider details
- NPI number
- 1558576322
- Entity type
- Organization
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Cathy Dean, Administrator(800) 485-8640
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-05-14
- Last updated
- 2020-08-22
Frequently asked questions
- What is Great Lakes Dermatology's NPI number?
- Great Lakes Dermatology's National Provider Identifier (NPI) is 1558576322, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Great Lakes Dermatology?
- Great Lakes Dermatology is classified in the NPPES registry as Procedural Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Great Lakes Dermatology located?
- Great Lakes Dermatology's practice location on file with NPPES is 3601 30th Ave, Kenosha, WI 53144-1695.
- What is Great Lakes Dermatology's phone number?
- The practice phone number listed in the NPPES registry for Great Lakes Dermatology is (262) 658-2594.
- Who is the authorized official for Great Lakes Dermatology?
- The authorized official listed on Great Lakes Dermatology's NPPES record is Cathy Dean, Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Great Lakes Dermatology's NPI active?
- Yes — Great Lakes Dermatology's NPI (1558576322) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.