Pain Centers of Wisconsin - Kenosha, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PAIN CENTERS OF WISCONSIN - KENOSHA, LLC

Practice address

9697 Saint Catherines Dr
Ste 102
Pleasant Prairie, WI 53158-2118

Phone

(414) 325-7246

NPI assigned

Feb 1, 2011

Organization subpart

No

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

Authorized official

Name

Vishal Lal

Title

Ceo

Phone

(414) 325-7246

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1407152945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9697 SAINT CATHERINES DR",
            "address_2": "STE 102",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582118",
            "telephone_number": "414-325-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9697 SAINT CATHERINES DR",
            "address_2": "STE 102",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582118",
            "telephone_number": "414-325-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CENTERS OF WISCONSIN - KENOSHA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-01",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "LAL",
        "authorized_official_first_name": "VISHAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-325-7246"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherri Lynn O'Shea, RDN, CD
• Old Oaks Dental LLC
• Dennis M Orellana Bonilla, NP
• Matthew J. Orzel, PA
• Stephanie Paff, BCBA
• Kyeong Soo Park
• Tessica Hallie Parsons, PHARM D
• Kunal Patel, M.D.
• Ruchi C Patel, B.PHARM
• Vraj Patel, DDS

• Ambulatory Surgical Clinic/Center in Pleasant Prairie, WI
• Providers in Pleasant Prairie, WI by specialty
• Ambulatory Surgical Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.