GREAT LAKES NEUROSURGICAL ASSOCIATES LLC (NPI# 1134317738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134317738 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES NEUROSURGICAL ASSOCIATES LLC |
| Practice Address |
2901 W Kinnickinnic River Parkway Suite 300 Milwaukee WI 53215 |
| Practice Telephone | 4143858702 |
| Mailing Telephone | 4143858702 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2013-05-17 |
| Authorized Official Name | YASHIIP SINGH PANNU (OWNER) |
| Authorized Official Telephone | 4143858702 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207T00000X | Neurological Surgery | 45579-20 | WI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578743019 | Great Lakes Neurosurgical Associates LLC | Neurological Surgery | 10400 75th St, Kenosha, WI 53142-7884 | 2007-11-13 |
| 1457531899 | Great Lakes Neurosurgical Associates LLC | Neurological Surgery | 8400 Washington Ave, Racine, WI 53406-3735 | 2007-11-13 |
| Street Address |
2901 W KINNICKINNIC RIVER PARKWAY SUITE 300 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013093178 | Cully R White | Neurological Surgery | 2901 W Kinnickinnic River Parkway, Suite 201, Milwaukee, WI 53215 | 2006-10-31 |
| 1124270947 | Adam Matthew Berman | Psychologist | 2901 W Kinnickinnic River Parkway, Ste 516 Medical Psychology Association, Milwaukee, WI 54985 | 2008-10-13 |
| 1932381449 | Dr. Cully R. White, Neurosurgery & Spine Sc | Neurological Surgery | 2901 W Kinnickinnic River Parkway, Suite 201, Milwaukee, WI 53215 | 2007-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841829918 | Joshua Michael Brooks | Student in an Organized Health Care Education/Training Program | Aurora St. Lukes Medical Center 2901 W Oklahoma Ave, Milwaukee, WI 53215 | 2020-04-02 |
| 1053967091 | Kristina Strupp | Clinical Nurse Specialist | 2900 W. Oaklahoma Avenue, Milwaukee, WI 53215 | 2019-08-15 |
| 1427510296 | Madelyn Pickle | Student in an Organized Health Care Education/Training Program | 2801 W. Kinnickinnic Rd Ste 250, Milwaukee, WI 53215 | 2019-04-02 |
| 1932601838 | Elizabeth D Morawski | Nurse Practitioner | 2801 Kinnickinnic Parkway, Suite 630, Milwaukee, WI 53215 | 2018-03-06 |
| 1457872673 | Canzata Kimberly Dent | Counselor | 2727 W. Cleveland Suite 204, Milwaukee, WI 53215 | 2017-06-28 |
| 1538689955 | Christian Pena | Durable Medical Equipment & Medical Supplies | 2800 W Forest Home Ave, Suite 100, Milwaukee, WI 53215 | 2017-06-27 |
| 1386178804 | Dane A Olsen | Family Medicine | 801 W Kinnickinnic River Pkwy., Suite 250, Milwaukee, WI 53215 | 2017-04-12 |
| 1811443492 | Thomas Diamond | Physical Therapist | 2901 Kinnickinnic Parkway, Milwaukee, WI 53215 | 2016-09-01 |
| 1487055133 | Sam Khalili | Otolaryngology | 2801 W Kinnickinnic River Pkwy # 680, Milwaukee, WI 53215 | 2014-09-12 |
| 1992105621 | Nicole R Hall | Nurse Practitioner | 2901 S Kinnickinnic Ave, Milwaukee, WI 53215 | 2014-08-29 |
| Find all providers in zip 53215 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952545014 | Irene Kim | Neurological Surgery | 999 N 92nd St Ste 310, Milwaukee, WI 53226-4875 | 2009-04-20 |
| 1649419169 | Walter P Jacobsen | Neurological Surgery | 2801 W Kinnickinnic River Pkwy Ste 680, Milwaukee, WI 53215-3669 | 2009-02-05 |
| 1013093178 | Cully R White | Neurological Surgery | 2901 W Kinnickinnic River Parkway, Suite 201, Milwaukee, WI 53215 | 2006-10-31 |
| 1235232810 | Neurological Surgery Sc | Neurological Surgery | 3201 So 16th Street, Suite 2025, Milwaukee, WI 53215-4534 | 2006-09-07 |
| 1194346585 | Mohammed Yanallah Alghamdi | Neurological Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-04-27 |
| 1801356878 | Omar M Hussain | Neurological Surgery | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2019-03-25 |
| 1073005971 | Huy Q Truong | Neurological Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2018-06-06 |
| 1093183543 | Raphael Sacho | Neurological Surgery | 9200 W. Wisconsin Avenue, Department of Neurosurgery, Milwaukee, WI 53226-3522 | 2015-09-14 |
| 1528453453 | Karl Walter Janich | Neurological Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2015-03-30 |
| 1801288816 | Mohamed Am Labib | Neurological Surgery | 2801 W Kinnickinnic River Pkwy, Suite 630, Milwaukee, WI 53215-3669 | 2015-02-27 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.