KENOSHA RADIOLOGY CENTER LLC.


Address: 10117 74th St, Suite 150, Kenosha, WI 53142-7533
Phone: 2626977770

KENOSHA RADIOLOGY CENTER LLC. (NPI# 1770540130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770540130
Entity Type Organization
Organization Name KENOSHA RADIOLOGY CENTER LLC.
Practice Address 10117 74th St
Suite 150
Kenosha
WI 53142-7533
Practice Telephone 2626977770
Practice Fax Number 2626977771
Mailing Telephone 2626977770
Mailing Fax Number 2626977771
Enumeration Date 2006-04-28
Last Update Date 2020-08-22
Authorized Official Name DR. JOHN S. PALLIN (PRESIDENT)
Authorized Official Telephone 2626977770
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0200X Clinic/Center
Specialization: Radiology
XM310472 WI Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
WI 21255800 05

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities KENOSHA RADIOLOGY CENTER LLC 10117 74th St Ste 150, Kenosha, WI 53142-7533

Office Location

Street Address 10117 74TH ST
SUITE 150
City KENOSHA
State WI
Zip Code 53142-7533

Providers in the same location

NPI Name Taxonomy Address Enumeration
1770853574 Theresa N Otu Counselor 10117 74th St, Suite 100, Kenosha, WI 53142-7533 2012-01-10
1336353572 Susan Mueller Counselor 10117 74th St, Suite 100, Kenosha, WI 53142-7533 2007-05-09
1780707232 Stacey Wright Marriage & Family Therapist 10117 74th St, Suite 100, Kenosha, WI 53142-7533 2007-04-09
1770640617 Jane Cary Pallin Specialist 10117 74th St, Suite 150, Kenosha, WI 53142-7533 2007-01-02
1790842631 John S Pallin Specialist 10117 74th St, Suite 150, Kenosha, WI 53142-7533 2007-01-02

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1588297816 Caring Hearts Home Health Care In Home Supportive Care 6021-57th Ave, Suite C103, Kenosha, WI 53142 2020-02-14
1144785395 Michael L Wrzesinski Counselor 4109 67th Street, Kenosha, WI 53142 2019-02-01
1720538499 David Smith Counselor 10900 67th Street, Kenosha, WI 53142 2016-10-06
1326404641 Smile Doctors Ltd Dentist 7003 39th Ave, Kenosha, WI 53142 2016-01-04
1225409485 Antonia Marie Decker Physician Assistant 10400 75th St. Ste 204, Kenosha, WI 53142 2015-10-14
1780060582 Joshua Haas Pharmacist 7701 Green Bay Road, Kenosha, IL 53142 2015-08-04
1811379225 Dana Mary Stout Registered Nurse 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 2015-06-22
1669815569 Joshua Knute Elson Radiology 6811 118th Ave, Kenosha, WI 53142 2013-04-10
1356610166 Michael J Gallo Pharmacist 7535 North Greenbay Rd, Kenosha, WI 53142 2011-12-22
1720357999 Orest Carnevale Registered Nurse 7316 155th Ct, Kenosha, WI 53142 2011-12-18
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Taxonomy Information

Taxonomy Code 261QR0200X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Radiology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649607623 Touhy Diagnostic At Home LLC Clinic/Center 723 58th St, 304, Kenosha, WI 53140-4160 2013-10-04
1215112966 Mh Imaging-kenosha LLC Clinic/Center 1020 35th Street, Suite 120, Kenosha, WI 53140-1932 2007-12-31

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1649435876 Luck Medical Clinic Clinic/Center 137 1st Ave, Luck, WI 54853 2008-07-28
1144392275 St Mary's Dean Ventures Inc Clinic/Center 1313 Fish Hatchery Road, Madison, WI 53715 2006-11-14
1033121629 Pediatric Diagnostic Imaging, S.c. Clinic/Center 8522 W Capitol Dr, Milwaukee, WI 53222-1827 2006-08-12
1528013992 Open Mri of Delafield, LLC Clinic/Center 3960 Hillside Dr, Suite 106, Delafield, WI 53018-2148 2006-05-24
1184675506 Cardiac Evaluation Services Inc Clinic/Center 2063 South 116th Street, Milwaukee, WI 53227 2006-05-12
1295784726 Mcmc Radiology Services, LLC Clinic/Center 5310 W Capitol Dr, Milwaukee, WI 53216-2239 2006-05-10
1073592473 Advanced Imaging S.c. Clinic/Center 228 S 18th Ave, Sturgeon Bay, WI 54235-1000 2006-01-13
1669865705 Oakleaf Clinics Sc Clinic/Center 3802 Oakwood Mall Dr, Eau Claire, WI 54701-3016 2015-03-13
1467710772 Affiliated Medical Imaging Clinic/Center 5310 W Capitol Dr, Suite 108, Milwaukee, WI 53216-2263 2012-04-25
1598056335 Germantown Medical Imaging, LLC Clinic/Center W178n9912 Rivercrest Dr, Suite 102-a, Germantown, WI 53022-4645 2011-04-27
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Competitor

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City KENOSHA
Zip Code 53142

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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