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GREAT LAKES SURGERY CENTER LLC
NPI 1700045168
Clinic/Center - Ambulatory Surgical in Kenosha, WI

Active since June 02, 2008
6123 GREEN BAY RD, SUITE 100, KENOSHA, WI 53142(262) 657-3668 Get Directions Write a Review

NPPES record last updated: March 23, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Great Lakes Surgery Center Llc NPPES

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

GREAT LAKES SURGERY CENTER LLC (NPI 1700045168) is a healthcare organization registered as an ambulatory surgical in Kenosha, Wisconsin and active in the NPI registry since June 2008. The organization lists Lisa K Thiery, Manager, as its authorized official.

NPPES Registry Identity

NPI1700045168
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameGREAT LAKES SURGERY CENTER LLC
Location Address6123 GREEN BAY RD, SUITE 100Kenosha, WI 53142-2927
Mailing AddressPo Box 580772Pleasant Prairie, WI 53158-8101 · (262) 657-3668
Phone(262) 657-3668
Organization SubpartNo
Authorized OfficialLisa K ThieryManager · (262) 657-3668
Enumeration DateJune 2, 2008
Last NPPES UpdateMarch 23, 2011
✔ NPI 1700045168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License✔ Licensed in WI · PENDING
6123 GREEN BAY RD, Kenosha, WI 53142
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Other Providers at the Same Location NPPES 12

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

DR. RODRIGO BUENCAMINO MATA III M.D.
Internal Medicine
6123 GREEN BAY RD, SUITE 120
KENOSHA, WI 53142
Kenosha County (262) 652-2710
MRS. TAREY ANN WENNINGER P.T.,
Physical Therapist
6123 GREEN BAY RD, SUITE 140
KENOSHA, WI 53142
Kenosha County (262) 653-9208
GREAT LAKES FAMILY MEDICAL CENTER INC
Clinic/Center
6123 GREEN BAY RD, SUITE 120
KENOSHA, WI 53142
Kenosha County (262) 764-4390
RODRIGO A MATA JR. M.D.
Family Medicine
6123 GREEN BAY RD, SUITE 120
KENOSHA, WI 53142
Kenosha County (262) 652-6995
GREAT LAKES FOOT & ANKLE CENTERS INC
Podiatrist (Foot & Ankle Surgery)
6123 GREEN BAY RD, SUITE 100
KENOSHA, WI 53142
Kenosha County (262) 652-3668
DR THOMAS J SOLECKI JR SC
Chiropractor
6123 GREEN BAY RD, SUITE 140
KENOSHA, WI 53142
Kenosha County (262) 653-9208
DR. KALPANA RAO PHD
Psychologist (Clinical)
6123 GREEN BAY RD
KENOSHA, WI 53142
Kenosha County (262) 948-1000
TODD'S COMPANIONPLUS, INC.
Home Health
6123 GREEN BAY RD, SUITE 230
KENOSHA, WI 53142
Kenosha County (262) 842-0405

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 Surgery Center LLC's NPI number?

The NPI number for Great Lakes Surgery Center LLC is 1700045168. It was assigned to this organization in the NPPES registry on June 2, 2008.

Where is Great Lakes Surgery Center LLC located?

Great Lakes Surgery Center LLC is located at 6123 Green Bay Rd Suite 100, Kenosha, WI 53142. The listed phone number is (262) 657-3668.

What is Great Lakes Surgery Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

When was this NPI record last updated?

The NPPES record for Great Lakes Surgery Center LLC was last updated on March 23, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.