| Lakeview Health, Llc | |
|
800 Goold St Racine WI 53402-4567 | |
| (262) 456-2182 | |
| (262) 456-2457 |
| Full Name | Lakeview Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 Goold St, Racine, Wisconsin |
| Authorized Official Name and Position | Glen Bordak (OWNER) |
| Authorized Official Contact | 2624980432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeview Health, Llc 800 Goold St Racine WI 53402-4567 Ph: (262) 456-2182 | Lakeview Health, Llc 800 Goold St Racine WI 53402-4567 Ph: (262) 456-2182 |
| NPI Number | 1679254700 |
|---|---|
| Provider Enumeration Date | 07/31/2023 |
| Last Update Date | 07/31/2023 |
| Medicare PECOS PAC ID | 2860847100 |
|---|---|
| Medicare Enrollment ID | O20231006000899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679254700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Glen A Bordak |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1588683718 PECOS PAC ID: 4486558020 Enrollment ID: I20031210000958 |
| Provider Name | Cynthia R Cernak |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1467493197 PECOS PAC ID: 9739142621 Enrollment ID: I20041115000472 |
| Provider Name | Steven L Armus |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1982601704 PECOS PAC ID: 7517937451 Enrollment ID: I20041203000885 |
| Provider Name | Mark E Decheck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134129380 PECOS PAC ID: 3072602051 Enrollment ID: I20071128000358 |
| Provider Name | Frances M Dossett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851093769 PECOS PAC ID: 1153786009 Enrollment ID: I20230427001067 |
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