# SHEBOYGAN MEDICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366487241
- **Authorized official:** MR. VISHAL LAL (EXECUTIVE ADMINISTRATOR)
- **Authorized official phone:** (414) 325-7246

## Contact information

- **Practice address:** 2124 KOHLER MEMORIAL DR, STE 100, SHEBOYGAN, WI 53081
- **Practice address phone:** (920) 452-7246
- **Practice address fax:** (920) 452-7388
- **Mailing address:** 4131 W LOOMIS RD, STE 800, GREENFIELD, WI 53221
- **Mailing address phone:** (414) 325-7246
- **Mailing address fax:** (414) 325-3770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 10/24/2016