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

Lakeshore Medical Clinic

Organization Nurse Practitioner · NPI 1053748160

Lakeshore Medical Clinic is a Nurse Practitioner in South Milwaukee, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2013.

Licensed in
WI
In the registry since
2013

Practice location Address checks out

100 15th Ave
South Milwaukee, WI 53172-1160
Phone: (414) 764-3241
Fax: (414) 762-4225
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 5513-33 (WI)

Record details

NPI number1053748160
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Frank Lavora — President · (414) 764-3241
NPI enumeratedOctober 3, 2013
Last updated in NPPESOctober 3, 2013
Mailing address100 15th Ave, South Milwaukee, WI 53172-1160

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