Kenosha Pediatrics

LBN: Children'S Medical Group
Kenosha Pediatrics is an health care organization with primary practice located at 6809 122Nd Ave , Kenosha WI 53142-7335. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Children'S Medical Group can be contacted via phone (262) 654-8633, or through Khare, Smriti via phone (414) 266-7615.

Contact Information

Primary practice address
6809 122Nd Ave Kenosha WI 53142-7335
Phone: (262) 654-8633
Fax: (262) 654-5467
Website:
Map and Directions
Authorized official contact:
Name: Khare, Smriti Doctor of Medicine (MD)
Phone: (414) 266-7615

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1740455096
LBN Legal business name Children'S Medical Group
DBA Doing business as Kenosha Pediatrics
Authorized official Khare, Smriti Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 28th, 2008
Last updated Feb 5th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740455096 NPPES
Wisconsin MEDICAID 32854500

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