LAKESIDE DIAGNOSTIC IMAGING LLC (NPI# 1407898992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407898992 |
| Entity Type | Organization |
| Organization Name | LAKESIDE DIAGNOSTIC IMAGING LLC |
| Practice Address |
4601 N Oakland Ave Shorewood WI 53211-1232 |
| Mailing Address |
6400 Industrial Loop Greendale WI 53129-2452 |
| Practice Telephone | 4149644601 |
| Practice Fax Number | 4149644616 |
| Mailing Telephone | 4144234100 |
| Mailing Fax Number | 4144234134 |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRUCE W CARDONE (PRESIDENT) |
| Authorized Official Telephone | 4149644601 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
4601 N OAKLAND AVE |
| City | SHOREWOOD |
| State | WI |
| Zip Code | 53211-1232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326019548 | Gfi Radiology Inc | Radiology | 4601 N Oakland Ave, Shorewood, WI 53211-1232 | 2006-01-27 |
| 1396102711 | Laura Christine Gillis | Acupuncturist | 4601 N Oakland Ave, Shorewood, WI 53211-1232 | 2016-01-16 |
| 1104005248 | Lifesteps Wellness Clinic | Internal Medicine | 4601 N Oakland Ave, Shorewood, WI 53211-1232 | 2007-10-25 |
| 1548469455 | Jennifer E Tribble | Radiology | 4601 N Oakland Ave, Shorewood, WI 53211-1232 | 2007-07-12 |
| 1730197161 | Bif Imaging LLC | Radiology | 4601 N Oakland Ave, Shorewood, WI 53211-1232 | 2006-08-03 |
| 1639111016 | Lakeside Diagnostic Imaging Center, LLC | Radiology | 4601 N Oakland Ave, Shorewood, WI 53211-1232 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
| Find all providers in zip 53211 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710427737 | Dorothea A Nazos | Radiology | 1810 Parkside Dr, Shorewood, IL 60404-0684 | 2017-02-24 |
| 1326019548 | Gfi Radiology Inc | Radiology | 4601 N Oakland Ave, Shorewood, WI 53211-1232 | 2006-01-27 |
| 1548469455 | Jennifer E Tribble | Radiology | 4601 N Oakland Ave, Shorewood, WI 53211-1232 | 2007-07-12 |
| 1730197161 | Bif Imaging LLC | Radiology | 4601 N Oakland Ave, Shorewood, WI 53211-1232 | 2006-08-03 |
| 1639111016 | Lakeside Diagnostic Imaging Center, LLC | Radiology | 4601 N Oakland Ave, Shorewood, WI 53211-1232 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264511 | Howard Simon Md PC | Radiology | 3960 Hillside Dr Ste 106, Delafield, WI 53018-2148 | 2020-08-04 |
| 1952951154 | Premier Radiology Wisconsin, LLC | Radiology | 10180 Washington Ave Ste 101, Mt Pleasant, WI 53177-1604 | 2019-09-19 |
| 1013478635 | Troy Nelson Tenbrunsel | Radiology | Uw Hospitals & Clinics 600 Highland Road, Madison, WI 53792-0001 | 2019-03-27 |
| 1336660216 | Kevin Shuai Lian | Radiology | 420 W Dayton St Unit 1142, Madison, WI 53703 | 2017-06-30 |
| 1346774726 | Molly Peterson | Radiology | 2639 University Ave Ste 201, Madison, WI 53705-3750 | 2017-04-12 |
| 1821445107 | Ryan Griesbach | Radiology | Uw Hospitals and Clinic, 600 Highland Ave, Madison, WI 53792-0001 | 2016-05-17 |
| 1629442181 | Dysphagia Testing, LLC | Radiology | 10638 Hidden Creek Dr, Mequon, WI 53092-8538 | 2015-11-20 |
| 1679987341 | Daniel Joseph Baumel | Radiology | 513 Clifden Dr, Madison, WI 53711-1530 | 2014-06-20 |
| 1235549247 | Benjamin Sawatzky | Radiology | 9 S Marquette St, Madison, WI 53704-5117 | 2014-04-29 |
| 1285054064 | Matthew Gregory Pipho | Radiology | 9306 Briar Haven Dr, Verona, WI 53593-8791 | 2014-04-21 |
| Find all providers with the same taxonomy | ||||
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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.