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Great Lakes Surgery LLC

Ambulatory Surgical Clinic/Center in Kenosha, WI · enumerated 2017 · authorized official John Bostanche, Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1629518006

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Registry record

Entity type Organization (Type 2)
Legal business name Great Lakes Surgery LLC
Practice address 6123 Green Bay Rd Ste 101, Kenosha, WI, 53142
Phone (262) 657-0224
Enumeration date Mar 3, 2017
Last updated in NPPES Mar 3, 2017

Taxonomy & classification

261QA1903X Ambulatory Surgical Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name John Bostanche
Title Director
Phone (262) 657-0224

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Great Lakes Surgery LLC?
The NPI for Great Lakes Surgery LLC is 1629518006, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Great Lakes Surgery LLC?
NPPES lists John Bostanche (Director) as the authorized official for this organization.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2017-03-03.