LAKESHORE MEDICAL CLINIC LLC (NPI# 1154840163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154840163 |
| Entity Type | Organization |
| Organization Name | LAKESHORE MEDICAL CLINIC LLC |
| Practice Address |
200 E Ryan Rd Oak Creek WI 53154-4563 |
| Mailing Address |
3301 W Forest Home Ave Milwaukee WI 53215-2843 |
| Practice Telephone | 4145703590 |
| Practice Fax Number | 4145703599 |
| Mailing Telephone | 4146476326 |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2017-09-12 |
| Authorized Official Name | GAIL HANSON (CFO) |
| Authorized Official Telephone | 4142991623 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538351549 | Lakeshore Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 4448 W Loomis Rd Ste 204, Greenfield, WI 53220-4851 | 2007-08-14 |
| 1497983837 | Lakeshore Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 4202 W Oakwood Park Ct, Franklin, WI 53132-8131 | 2009-06-24 |
| 1639374036 | Lakeshore Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 331 E Puetz Rd, Oak Creek, WI 53154-3254 | 2007-06-18 |
| 1265597645 | Lakeshore Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2006-12-26 |
| Street Address |
200 E RYAN RD |
| City | OAK CREEK |
| State | WI |
| Zip Code | 53154-4563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780637538 | Lisa A O'brien | Physician Assistant | 200 E Ryan Rd, Oak Creek, WI 53154-4563 | 2006-05-19 |
| 1013495068 | Samuel E Kaminski | Nurse Practitioner | 200 E Ryan Rd, Oak Creek, WI 53154-4563 | 2018-08-01 |
| 1548756281 | Amanpreet Dhaliwal | Family Medicine | 200 E Ryan Rd, Oak Creek, WI 53154 | 2018-07-05 |
| 1538536800 | Saul Hernandez, Jr. | Physician Assistant | 200 E Ryan Rd, Oak Creek, WI 53154-4563 | 2015-08-21 |
| 1124413935 | Nabila Quadri | Emergency Medicine | 200 E Ryan Rd, Oak Creek, WI 53154-4563 | 2015-03-30 |
| 1780091959 | Shilpa Chaku | Psychiatry & Neurology | 200 E Ryan Rd, Oak Creek, WI 53154-4563 | 2014-07-18 |
| 1457694432 | Ivonne Lopez | Nurse Practitioner | 200 E Ryan Rd, Oak Creek, WI 53154-4563 | 2013-03-28 |
| 1417234428 | Lynne Nevers-hoeft | Nurse Practitioner | 200 E Ryan Rd, Oak Creek, WI 53154-4563 | 2011-11-05 |
| 1285949420 | Steve M Czymbor | Podiatrist | 200 E Ryan Rd, Oak Creek, WI 53154 | 2010-08-12 |
| 1306096532 | Nicole Rivecca | Physician Assistant | 200 E Ryan Rd, Suite 101, Oak Creek, WI 53154-4533 | 2008-09-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235762881 | Imr Oak Creek Opco, LLC | Skilled Nursing Facility | 2700 West Honadel Boulevard, Oak Creek, WI 53154 | 2020-02-21 |
| 1619512605 | Sharon Boushon | Technician | 642 E Pergola Place, Oak Creek, WI 53154 | 2019-11-13 |
| 1255991386 | Jodi Kruszka | Nurse Practitioner | 825 E Manitowoc Avenue, Oak Creek, WI 53154 | 2019-06-20 |
| 1184288896 | Thomas Carl Jonson | Durable Medical Equipment & Medical Supplies | 9036 S Carollton Dr., Oak Creek, WI 53154 | 2019-04-29 |
| 1982127577 | Zainab Saddiq | Optometrist | 8661 S. Howell Ave, 200, Oak Creek, WI 53154 | 2017-07-25 |
| 1649700980 | Froedtert & The Medical College of Wisconsin Community Physicians, Inc | Durable Medical Equipment & Medical Supplies | 7901 South 6th Street, Oak Creek, WI 53154 | 2017-06-19 |
| 1770969578 | Suhani Virparia | Pharmacist | 171 W. Town Square Way, Oak Creek, WI 53154 | 2015-08-04 |
| 1275919144 | Jessica Ford | Social Worker | 8825 South Howell Avenue, Suite 305, Oak Creek, WISCONSIN 53154 | 2015-08-03 |
| 1700269388 | Tarnit Singh Kapoor | Dentist | 8421 Howell Ave, Oak Creek, WI 53154 | 2015-07-01 |
| 1447656350 | Kiersten Kirking | Physical Therapist | 210 W. Raindbow Ridge Dr., 1207, Oak Creek, WI 53154 | 2014-11-05 |
| Find all providers in zip 53154 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649700980 | Froedtert & The Medical College of Wisconsin Community Physicians, Inc | Durable Medical Equipment & Medical Supplies | 7901 South 6th Street, Oak Creek, WI 53154 | 2017-06-19 |
| 1003296518 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 171 W Town Square Way, Oak Creek, WI 53154-6801 | 2015-06-01 |
| 1245590892 | Eastern Dme | Durable Medical Equipment & Medical Supplies | 6508 S 27th St, Suite 9-194, Oak Creek, WI 53154-1093 | 2012-05-16 |
| 1932401908 | Purerfid, Inc. | Durable Medical Equipment & Medical Supplies | 9817 S 13th St, Oak Creek, WI 53154-4923 | 2010-11-24 |
| 1053326108 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 9449 S Howell Ave, Oak Creek, WI 53154-4431 | 2006-07-29 |
| 1104848704 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8989 S Howell Ave, Oak Creek, WI 53154-3803 | 2006-07-24 |
| 1649252412 | Rehabtech Inc. | Durable Medical Equipment & Medical Supplies | 440 W Bell Ct, Suite 400, Oak Creek, WI 53154-8322 | 2005-11-17 |
| 1528237229 | Sleepmed Therapies Inc | Durable Medical Equipment & Medical Supplies | 8825 S Howell Ave, #101, Oak Creek, WI 53154-3760 | 2008-02-27 |
| 1639374036 | Lakeshore Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 331 E Puetz Rd, Oak Creek, WI 53154-3254 | 2007-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659983070 | Midwest Respiratory Care Inc | Durable Medical Equipment & Medical Supplies | 507 Jefferson St E # 34, West Salem, WI 54669-9560 | 2020-08-18 |
| 1356959506 | A Journey Home Medsupply | Durable Medical Equipment & Medical Supplies | 9575 W Fond Du Lac Ave Apt 19, Milwaukee, WI 53225-1645 | 2020-07-14 |
| 1801410097 | Discountramps.com LLC | Durable Medical Equipment & Medical Supplies | N102w19400 Willow Creek Way, Germantown, WI 53022-3703 | 2020-06-03 |
| 1861016404 | Active Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 1233 N Mayfair Rd Ste 120, Wauwatosa, WI 53226-3255 | 2020-05-29 |
| 1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
| 1114551165 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3536 52nd St Ste P, Kenosha, WI 53144-2662 | 2020-02-28 |
| 1972137842 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 4635 W College Ave Ste 114, Appleton, WI 54914-8507 | 2020-02-28 |
| 1104458140 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 1818 S. Rapids Rd, Manitowoc, WI 54220-9302 | 2020-02-07 |
| 1619511599 | Xceed Medical, LLC | Durable Medical Equipment & Medical Supplies | 5307 S 92nd St Ste 125, Hales Corners, WI 53130-1677 | 2019-11-04 |
| 1922641877 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | W234s3555 Les Paul Pkwy, Waukesha, WI 53189-8512 | 2019-10-23 |
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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.