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NEUROTECH, LLC FIXED IDTF
NPI 1336780717
Physiological Laboratory in Green Bay, WI

Active since October 07, 2019
1263 MAIN ST STE 120, GREEN BAY, WI 54302(262) 875-6612 Get Directions Write a Review

NPPES record last updated: November 12, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 12, 2021, Dec 1, 2020, Oct 7, 2019 (3 updates tracked since 2019).

About Neurotech, Llc Fixed Idtf NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NEUROTECH, LLC FIXED IDTF (NPI 1336780717) is a healthcare organization registered as a physiological laboratory in Green Bay, Wisconsin and active in the NPI registry since October 2019. The organization lists Kristine Lisa Wildner, Director Of Contracting & Research, as its authorized official.

NPPES Registry Identity

NPI1336780717
Entity TypeOrganization
Primary Taxonomy293D00000X
Legal Business NameNEUROTECH, LLC
Location Address1263 MAIN ST STE 120Green Bay, WI 54302-1341
Mailing Address3232 Ridge Rd, Suite 5Lansing, IL 60438-3127 · (708) 889-6096
Phone(262) 875-6612
Organization SubpartNo
Authorized OfficialKristine Lisa WildnerDirector Of Contracting & Research · (262) 875-6572
Enumeration DateOctober 7, 2019
Last NPPES UpdateNovember 12, 20213 updates tracked since enumeration
NPPES CertifiedNovember 12, 2021
✔ NPI 1336780717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPhysiological LaboratoryLaboratories
Taxonomy Code293D00000X
Definition
A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.
Also ListedTechnician, Other · EEGTaxonomy 2472E0500X
Also ListedClinic/Center · Sleep Disorder DiagnosticTaxonomy 261QS1200X
Also ListedPortable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy 335V00000X
1263 MAIN ST STE 120, Green Bay, WI 54302
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Other Names 1

Other NameNeurotech, Llc Fixed Idtf

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Neurotech, LLC's NPI number?

The NPI number for Neurotech, LLC is 1336780717. It was assigned to this organization in the NPPES registry on October 7, 2019. The provider is also known as Neurotech, LLC Fixed Idtf.

Where is Neurotech, LLC located?

Neurotech, LLC is located at 1263 Main St Ste 120, Green Bay, WI 54302. The listed phone number is (262) 875-6612.

What is Neurotech, LLC's specialty?

The primary specialty registered for this NPI is Physiological Laboratory with taxonomy code 293D00000X.

When was this NPI record last updated?

The NPPES record for Neurotech, LLC was last updated on November 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.