| Kenosha Community Center Clinic | |
|
1330 52nd St Suite 205 Kenosha WI 53140-3236 | |
| (262) 656-0044 | |
| (262) 764-3636 |
| Full Name | Kenosha Community Center Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1330 52nd St, Kenosha, Wisconsin |
| Authorized Official Name and Position | Mary Coffey (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2627643608 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenosha Community Center Clinic 625 57th St Suite 700 Kenosha WI 53140-4146 Ph: (262) 656-0044 | Kenosha Community Center Clinic 1330 52nd St Suite 205 Kenosha WI 53140-3236 Ph: (262) 656-0044 |
| NPI Number | 1942595657 |
|---|---|
| Provider Enumeration Date | 06/10/2011 |
| Last Update Date | 07/23/2014 |
| Medicare PECOS PAC ID | 0941195168 |
|---|---|
| Medicare Enrollment ID | O20120308000344 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942595657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Steven Schwimmer, Do Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5455 Sheridan Rd, 201, Kenosha, WI 53140 Phone: 262-654-2500 Fax: 252-654-2701 | |
Leilane U Sta Romana Mdsc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3734 7th Ave, Dominican Building Suite 15, Kenosha, WI 53140 Phone: 262-658-3706 | |
Surya Medical Group Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6125 Green Bay Rd, Suite 100, Kenosha, WI 53142 Phone: 262-564-8636 | |
Genesis Medical Center Of Kenosha, S.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1020 35th St, Kenosha, WI 53140 Phone: 262-652-3500 Fax: 262-925-8353 | |
Great Lakes Family Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6123 Green Bay Rd, Suite 120, Kenosha, WI 53142 Phone: 262-764-4390 Fax: 262-764-4396 | |
Gevinah Healthcare Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3100 Washington Rd, Kenosha, WI 53144 Phone: 310-933-5688 | |
Regina Capelli-scheidt M.d,s.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3601 30th Ave, Kenosha, WI 53144 Phone: 262-658-8862 Fax: 262-658-8874 |