OrganizationActive
Great Lakes Neurosurgical Associates LLC
NPI 1578743019 · Neurological Surgery Physician · Kenosha, WI
Provider details
- NPI number
- 1578743019
- Entity type
- Organization
- Primary specialty
- Neurological Surgery PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Great Lakes Neurosurgical Associates LLC
- Organization subpart
- Yes
- Authorized official
- Yashdip Pannu, Owner(414) 385-8702
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
10400 75th St
Kenosha, WI 53142-7884
Phone: (262) 948-7000
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 241393
Milwaukee, WI 53224-9032
Registry dates
- Enumerated
- 2007-11-13
- Last updated
- 2013-05-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.