GREAT LAKES DERMATOLOGY
NPI 1689757569
Dermatology - Procedural Dermatology in Racine, WI

Q: What is Great Lakes Dermatology's NPI number?

The NPI number for Great Lakes Dermatology is 1689757569. It was assigned to this organization in the NPPES registry on October 23, 2006.

Q: What is Great Lakes Dermatology's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Active since October 23, 2006

1515 S GREENBAY RD, RACINE, WI 53406(262) 632-2074(262) 632-2656 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Great Lakes Dermatology NPPES

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

GREAT LAKES DERMATOLOGY (NPI 1689757569) is a healthcare organization registered as a procedural dermatology in Racine, Wisconsin and active in the NPI registry since October 2006. The organization lists Cathy J Dean, Administrator, as its authorized official.

NPPES Registry Identity

NPI1689757569

Entity TypeOrganization

Primary Taxonomy207NS0135X

Legal Business NameGREAT LAKES DERMATOLOGY

Location Address1515 S GREENBAY RDRacine, WI 53406-4409

Mailing Address1515 S Greenbay RdRacine, WI 53406-4409 · (262) 632-2074 · Fax (262) 632-2656

Phone(262) 632-2074

Fax(262) 632-2656

Organization SubpartNo

Authorized OfficialCathy J DeanAdministrator · (800) 485-8640

Enumeration DateOctober 23, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1689757569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207NS0135X

Definition

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

1515 S GREENBAY RD, Racine, WI 53406

Open in Google Maps ↗

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

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GANZ ALLERGY & ASTHMA CENTER SC

Allergy & Immunology (Allergy)

1515 S GREENBAY RD
RACINE, WI 53406

Racine County (262) 884-6080

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 Great Lakes Dermatology's NPI number?

The NPI number for Great Lakes Dermatology is 1689757569. It was assigned to this organization in the NPPES registry on October 23, 2006.

Where is Great Lakes Dermatology located?

Great Lakes Dermatology is located at 1515 S Greenbay Rd, Racine, WI 53406. The listed phone number is (262) 632-2074.

What is Great Lakes Dermatology's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

When was this NPI record last updated?

The NPPES record for Great Lakes Dermatology was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.