=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831044940
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASPIRUS MEDICAL GROUP, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2026
-----------------------------------------------------
Last Update Date | 03/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29980 NETWORK PL
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60673-1299
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-847-2304
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4005 COMMUNITY CENTER DR
-----------------------------------------------------
City | WESTON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54476-4139
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-241-5490
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SVP- CHIEF FINANCIAL OFFICER
-----------------------------------------------------
Name | LORI PECK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 715-847-2575
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------