# NORTH SHORE INTERNAL MEDICINE SPECIALIST, SC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1669642997
- **Authorized official:** MEHRAN EDALATPOUR MD (PRESIDENT)
- **Authorized official phone:** (262) 242-3369

## Contact information

- **Practice address:** 140 S MAIN ST, THIENSVILLE, WI 53092-1956
- **Practice address phone:** (262) 242-3369
- **Practice address fax:** (262) 242-3219
- **Mailing address:** 6400 INDUSTRIAL LOOP, GREENDALE, WI 53129-2452
- **Mailing address phone:** (414) 423-4100
- **Mailing address fax:** (414) 423-4134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |

## Other

- **Enumeration date:** 03/03/2008
- **Last updated:** 03/14/2008