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

Great Lakes Surgery Center LLC

Organization Ambulatory Surgical Clinic/Center · NPI 1700045168

Great Lakes Surgery Center LLC is an Ambulatory Surgical Clinic/Center in Kenosha, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2008.

Licensed in
WI
In the registry since
2008
What do these letters mean?
LLC — Limited liability company
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) 657-3668
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence PENDING (WI)

Record details

NPI number1700045168
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Thiery — Manager · (262) 657-3668
NPI enumeratedJune 2, 2008
Last updated in NPPESMarch 23, 2011
Mailing addressPo Box 580772, Pleasant Prairie, WI 53158-8101

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