Great Lakes Neurosurgical Associates LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

45579-20 Issued in WI

Legal business name

GREAT LAKES NEUROSURGICAL ASSOCIATES LLC

Practice address

2901 W Kinnickinnic River Parkway
Suite 300
Milwaukee, WI 53215

Phone

(414) 385-8702

NPI assigned

Oct 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yashiip Singh Pannu, MD

Title

Owner

Phone

(414) 385-8702

Specialties & licenses 2

Addresses

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Great Lakes Neurosurgical Associates LLC

  • Neurological Surgery Physician
  • Racine, WI
  • NPI 1457531899
  NPPES parent name
• Great Lakes Neurosurgical Associates LLC

  • Neurological Surgery Physician
  • Kenosha, WI
  • NPI 1578743019
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1134317738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PARKWAY",
            "address_2": "SUITE 300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-385-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PARKWAY",
            "address_2": "SUITE 300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-385-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES NEUROSURGICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "PANNU",
        "authorized_official_first_name": "YASHIIP",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-385-8702",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "WI",
            "license": "45579-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valena Grbic, MD
• Matthew J Grbich, D.C.
• Great Lakes Behavior Analysis, Inc.
• Great Lakes Home Health LLC
• Great Lakes Medical & Surgical Center
• Greater Heights Counseling
• Greater Milwaukee Critical Care and Pulmonary Associates SC
• Greater Milwaukee Health Services, S.C.
• Greater Milwaukee Medical Services
• Greater Milwaukee Surgical Associates SC

• Neurological Surgery Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Neurological Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.