OrganizationActive
Advanced Foot and Ankle Center of Kenosha S.c.
NPI 1104279561 · Podiatrist · Kenosha, WI
Provider details
- NPI number
- 1104279561
- Entity type
- Organization
- Primary specialty
- PodiatristPodiatric Medicine & Surgery Service Providers
- Organization subpart
- No
- Authorized official
- Dana Derouin, President(262) 652-6555
- License
- 1029-25 (WI)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Practice location
2901 35th St
Lower Level South
Kenosha, WI 53140-5117
Phone: (262) 652-6555
Approximate (ZIP-level) locationGet directions
Mailing address
2901 35th St
Kenosha, WI 53140-5117
Registry dates
- Enumerated
- 2016-07-20
- Last updated
- 2016-07-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.