Healthcare Provider Details

I. General information

NPI: 1700715521
Provider Name (Legal Business Name): LESCHKE SPINE AND NEUROSURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 S MADISON STREET
APPLETON WI
54915
US

IV. Provider business mailing address

4764 W INTEGRITY WAY # 175
APPLETON WI
54913-8464
US

V. Phone/Fax

Practice location:
  • Phone: 920-939-7868
  • Fax: 920-939-8031
Mailing address:
  • Phone: 920-939-7868
  • Fax: 920-939-8031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN M LESCHKE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 920-203-7761