| Great Lakes Foot & Ankle Centers Inc | |
|
6123 Green Bay Rd, Suite 100, Kenosha, WI 53142-2927 | |
| (262) 652-3668 | |
| (262) 652-0564 |
| Full Name | Great Lakes Foot & Ankle Centers Inc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 6123 Green Bay Rd, Kenosha, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295941409 | NPI | - | NPPES |
| 43215000 | Medicaid | WI | |
| 43237400 | Medicaid | WI | |
| 43220100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 016 (Illinois) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 025 (Wisconsin) | Primary |
| Provider Name | John L Bostanche |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821092420 PECOS PAC ID: 4385611490 Enrollment ID: I20040917000093 |
| Provider Name | Priya P Patel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1609396506 PECOS PAC ID: 7719256767 Enrollment ID: I20221013002711 |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Foot & Ankle Centers Inc 6123 Green Bay Rd, Suite 100, Kenosha, WI 53142-2927 Ph: (262) 652-3668 | Great Lakes Foot & Ankle Centers Inc 6123 Green Bay Rd, Suite 100, Kenosha, WI 53142-2927 Ph: (262) 652-3668 |
Dr. Michael Aaron Engel, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 7401 104th Ave, Suite 110, Kenosha, WI 53142 Phone: 262-764-5595 Fax: 262-764-9314 | |
Birute Balciunas, Dpm Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2901 35th St, Lower Level, Kenosha, WI 53140 Phone: 262-652-6555 Fax: 262-652-7414 | |
Patel Foot & Ankle Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 6123 Green Bay Rd Ste 100, Kenosha, WI 53142 Phone: 262-657-3668 Fax: 262-652-0564 | |
Advanced Foot And Ankle Center Of Kenosha S.c. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2901 35th St, Lower Level South, Kenosha, WI 53140 Phone: 262-652-6555 | |
Foot Factor Podiatry Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 6125 Green Bay Rd Ste 600, Kenosha, WI 53142 Phone: 877-287-1962 Fax: 877-287-1962 | |
Jeremy A Schwartz Dpm Wisconsin Ltd Podiatrist Medicare: Medicare Enrolled Practice Location: 8633 32nd Ave, Kenosha, WI 53142 Phone: 694-262-8300 | |
Gs Miceli Dpm, Sc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 7201 Green Bay Rd, Suite A, Kenosha, WI 53142 Phone: 262-925-6565 Fax: 262-697-4291 |