Lakeside Diagnostic Imaging LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

LAKESIDE DIAGNOSTIC IMAGING LLC

Practice address

4601 N Oakland Ave
Shorewood, WI 53211-1232

Phone

(414) 964-4601

Fax

(414) 964-4616

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Bruce W Cardone, MD

Title

President

Phone

(414) 964-4601

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407898992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 N OAKLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111232",
            "telephone_number": "414-964-4601",
            "fax_number": "414-964-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE DIAGNOSTIC IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARDONE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-964-4601",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Koeck, O.D.
• Kyle Konkol, LPC-IT
• Carol Kuhlow, MS LPC
• Rachel Ladin
• Lakeside Diagnostic Imaging Center, LLC
• Catherine G Larosa-Bell, LPC-IT
• Kristen Anne Larson, MS/CCC-SLP
• Laurie Reisener Counseling Services, LLC
• Hayley Leair, REGISTERED NURSE
• Shalonda Renee Leflore, MSW, LCSW

• Diagnostic Radiology Physician in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.