Healthcare Provider Details

I. General information

NPI: 1871815282
Provider Name (Legal Business Name): AURORA HEALTH CARE SOUTHERN LAKES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2010
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36500 AURORA DR
SUMMIT WI
53066-4899
US

IV. Provider business mailing address

36500 AURORA DR
OCONOMOWOC WI
53066-4899
US

V. Phone/Fax

Practice location:
  • Phone: 262-434-1000
  • Fax:
Mailing address:
  • Phone: 262-434-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: KARA RICHARDSON
Title or Position: ASSISTANT TREASURER
Credential:
Phone: 704-631-0450