LAKESHORE MEDICAL CLINIC, LLC (NPI# 1790980191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790980191 |
| Entity Type | Organization |
| Organization Name | LAKESHORE MEDICAL CLINIC, LLC |
| Practice Address |
3305 S 20th St Milwaukee WI 53215-4940 |
| Mailing Address |
3301 W Forest Home Ave Milwaukee WI 53215-2843 |
| Practice Telephone | 4146451808 |
| Mailing Telephone | 4146476326 |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2017-07-20 |
| Authorized Official Name | MICHAEL BANIA (SENIOR DIRECTOR) |
| Authorized Official Telephone | 4147669094 |
| 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 |
|---|---|---|---|---|
| 1922356252 | Lakeshore Medical Clinic, LLC | Durable Medical Equipment & Medical Supplies | S68w15500 Janesville Rd, Muskego, WI 53150-2613 | 2012-08-16 |
| 1669646287 | Lakeshore Medical Clinic, LLC | Durable Medical Equipment & Medical Supplies | 2000 E Layton Ave, Saint Francis, WI 53235-6053 | 2008-04-15 |
| 1962607366 | Lakeshore Medical Clinic, LLC | Durable Medical Equipment & Medical Supplies | 14555 W National Ave, Ste 165, New Berlin, WI 53151-4494 | 2007-06-18 |
| 1114087053 | Lakeshore Medical Clinic, LLC | Durable Medical Equipment & Medical Supplies | 3611 S Chicago Ave, South Milwaukee, WI 53172-3708 | 2006-12-11 |
| 1003861188 | Lakeshore Medical Clinic, LLC | Clinic/Center | 2000 E Layton Ave, Ste 100, Milwaukee, WI 53235-6053 | 2006-05-24 |
| Street Address |
3305 S 20TH ST |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53215-4940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922082312 | Navtej S Purewal | Anesthesiology | 3305 S 20th St, Suite 150, Milwaukee, WI 53215-4940 | 2005-11-30 |
| 1467923409 | Elizabeth M Ullig | Nurse Practitioner | 3305 S 20th St, Milwaukee, WI 53215-4940 | 2018-12-17 |
| 1902214612 | Ashley A Moriwaki | Nurse Practitioner | 3305 S 20th St, Ste 100, Milwaukee, WI 53215-4940 | 2014-07-25 |
| 1205240686 | Lakeshore Medical Clinic | Nurse Practitioner | 3305 S 20th St, Suite 100, Milwaukee, WI 53215-4940 | 2014-06-13 |
| 1679831655 | Melissa Renee Nowicki | Nurse Practitioner | 3305 S 20th St, Milwaukee, WI 53215-4940 | 2012-04-27 |
| 1922397660 | Arslan Zaidi | Anesthesiology | 3305 S 20th St, Suite 100, Milwaukee, WI 53215-4940 | 2011-04-04 |
| 1720394463 | Kong Her | Physician Assistant | 3305 S 20th St, Milwaukee, WI 53215-4940 | 2010-08-19 |
| 1013220185 | Michael A. Didion D.o.,s.c. | Anesthesiology | 3305 S 20th St, Suite 150, Milwaukee, WI 53215-4940 | 2010-07-19 |
| 1508021593 | Ifeyinwa N Igwe | Internal Medicine | 3305 S 20th St, Milwaukee, WI 53215-4940 | 2008-07-19 |
| 1619154952 | Pritika Bhatia, M.d., LLC. | Pain Medicine | 3305 S 20th St, Ste 150, Milwaukee, WI 53215-4940 | 2008-01-29 |
| Find all providers in the same location | ||||
| 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 | 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 |
|---|---|---|---|---|
| 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 |
| 1720629504 | Layton Pharmacy Sc | Durable Medical Equipment & Medical Supplies | 2741 W Layton Ave Ste 105, Milwaukee, WI 53221-2600 | 2019-10-03 |
| 1386205854 | Abbas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 10850 W Park Pl Ste 560, Milwaukee, WI 53224-3606 | 2019-06-25 |
| 1841753159 | Love Is Patient Medical Supplies | Durable Medical Equipment & Medical Supplies | 3525 N 64th St, Milwaukee, WI 53216-2724 | 2019-04-12 |
| 1790242352 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 6255 N Santa Monica Blvd, Milwaukee, WI 53217-4353 | 2019-03-01 |
| 1114494549 | Mirco Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 3808 N Teutonia Ave, Milwaukee, WI 53206-1950 | 2018-10-24 |
| 1538689955 | Christian Pena | Durable Medical Equipment & Medical Supplies | 2800 W Forest Home Ave, Suite 100, Milwaukee, WI 53215 | 2017-06-27 |
| 1861924250 | Us Dme Inc | Durable Medical Equipment & Medical Supplies | 2701 N Martin Luther King Dr, 101-3, Milwaukee, WI 53212-2311 | 2017-04-03 |
| 1346696796 | Respiratory and Sleep Services LLC | Durable Medical Equipment & Medical Supplies | 6529 W Fond Du Lac Avenue, Milwaukee, WI 53222 | 2016-05-04 |
| 1225401862 | Debbie Lewis | Durable Medical Equipment & Medical Supplies | 4229 W Courtland Ave, Milwaukee, WI 53209-5839 | 2015-11-04 |
| 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.