Kenosha Radiology Center Llc.

LBN: Kenosha Radiology Center Llc.
Kenosha Radiology Center Llc. is an health care organization with primary practice located at 10117 74Th St Suite 150, Kenosha WI 53142-7533. The organization recently has only one registered license in Ambulatory Health Care Facilities / Radiology, which is considered as the primary health care specialty. Kenosha Radiology Center Llc. can be contacted via phone (262) 697-7770, or through Pallin, John S. via phone (262) 697-7770.

Contact Information

Primary practice address
10117 74Th St Suite 150 Kenosha WI 53142-7533
Phone: (262) 697-7770
Fax: (262) 697-7771
Website:
Map and Directions
Authorized official contact:
Name: Pallin, John S. Doctor of Medicine (MD)
Phone: (262) 697-7770

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology 261QR0200X XM310472 Wisconsin

Profile Details

NPI number 1770540130
LBN Legal business name Kenosha Radiology Center Llc.
DBA Doing business as
Authorized official Pallin, John S. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 28th, 2006
Last updated Aug 22nd, 2020 - about 6 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 1770540130 NPPES
Wisconsin MEDICAID 21255800

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