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General NPI Number Information
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NPI Number | 1144165911
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Entity Type | Organization
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Legal Business Name | LAKESHORE NEUROWELLNESS & REHAB CENTER LLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 10750 W HOWARD AVE
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City | GREENFIELD
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State | WI
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Zip | 53228-1321
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Country | US
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Telephone | 414-239-6248
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Fax |
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Provider Business Mailing Address
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Address Line | 10750 W HOWARD AVE
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City | GREENFIELD
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State | WI
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Zip | 53228-1321
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTORY
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Name | CHRISTOPHER CRONSELL
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Credential | MD
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Telephone | 773-209-8464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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