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

Great Lakes Foot & Ankle Centers Inc

Organization Foot & Ankle Surgery Podiatrist · NPI 1295941409

Great Lakes Foot & Ankle Centers Inc is a Foot & Ankle Surgery Podiatrist in Kenosha, Wisconsin. Licensed in Illinois and Wisconsin. Registered with an NPI since 2007.

Licensed in
IL, WI
In the registry since
2007
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6123 Green Bay Rd Ste 100
Kenosha, WI 53142-2927
Phone: (262) 652-3668
Fax: (262) 652-0564
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence 025 (WI)
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X · Licence 016 (IL)

Record details

NPI number1295941409
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Bostanche — Physician/Owner · (262) 652-3668
NPI enumeratedMay 15, 2007
Last updated in NPPESSeptember 20, 2021
Certification dateSeptember 20, 2021
Mailing address6123 Green Bay Rd, Suite 100, Kenosha, WI 53142-2927

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