Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Great Lakes Dermatology

Organization Procedural Dermatology Physician · NPI 1689757569

Great Lakes Dermatology is a Procedural Dermatology Physician in Racine, Wisconsin. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

1515 S Greenbay Rd
Racine, WI 53406-4409
Phone: (262) 632-2074
Fax: (262) 632-2656
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Procedural Dermatology Physician (primary) Taxonomy 207NS0135X

Record details

NPI number1689757569
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cathy Dean — Administrator · (800) 485-8640
NPI enumeratedOctober 23, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1515 S Greenbay Rd, Racine, WI 53406-4409