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

Mind Neurology Wisconsin SC

Organization Medical Specialty Clinic/Center · NPI 1073242194

Mind Neurology Wisconsin SC is a Medical Specialty Clinic/Center in Mequon, Wisconsin. Works from 2 locations. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2

Practice location Address checks out

12200 Corporate Pkwy Ste 400
Mequon, WI 53092-3300
Phone: (414) 430-0069
Show map & directions

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

Additional practice locations (1)

  • 1725 N Casaloma Dr, Appleton, WI 54913-7916 — (888) 585-7975

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X
Urgent Care Clinic/Center Taxonomy 261QU0200X

Record details

NPI number1073242194
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacob Hart — Chief Operating Officer · (414) 430-0069
NPI enumeratedJune 6, 2022
Last updated in NPPESAugust 19, 2024
Certification dateAugust 19, 2024
Mailing address12200 Corporate Pkwy Ste 400, Mequon, WI 53092-3300

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