Organization
NEUROTECH, LLC
Active
Parent organization
NEUROTECH, LLC
Other names
Neurotech, LLC Homewood IL
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEUROTECH, LLC
Authorized official
MRS. KRISTINE LISA WILDNER (DIRECTOR OF CONTRACTING & RESEARCH)
(262) 875-6572
Entity
Organization
Contact information
Practice address
1820 RIDGE RD STE 303A, HOMEWOOD, IL 60430-1759
(708) 960-3997
(262) 754-0897
Mailing address
626 W MORELAND BLVD, WAUKESHA, WI 53188-2433
(262) 875-6572
(262) 754-0897
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
293D00000X
Physiological Laboratory
Primary
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
09/26/2018
Last updated
03/09/2019
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