Provider Demographics
NPI:1285802413
Name:INSIGHT NEURALMONITORING, INC.
Entity type:Organization
Organization Name:INSIGHT NEURALMONITORING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFRY
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:VEENHUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-522-3670
Mailing Address - Street 1:N17W24222 RIVERWOOD DR
Mailing Address - Street 2:SUITE 190
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1132
Mailing Address - Country:US
Mailing Address - Phone:262-522-3670
Mailing Address - Fax:262-522-3671
Practice Address - Street 1:N17W24222 RIVERWOOD DR
Practice Address - Street 2:SUITE 190
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1132
Practice Address - Country:US
Practice Address - Phone:262-522-3670
Practice Address - Fax:262-522-3671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI42460-0202084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000068402Medicare PIN
WIWI1114Medicare PIN
WI000071147Medicare PIN
MNC05116Medicare PIN
WI000045545Medicare PIN