OrganizationActive
Kenosha Kidney Dialysis LLC
NPI 1730219924 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Kenosha, WI
Provider details
- NPI number
- 1730219924
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jonathan Wilcox, Cfo(978) 922-3080
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
6125 Green Bay Rd
Suite 100
Kenosha, WI 53142-2942
Phone: (262) 652-1776
Fax: (262) 652-2702
Approximate (ZIP-level) locationGet directions
Mailing address
6125 Green Bay Rd
Kenosha, WI 53142-2942
Registry dates
- Enumerated
- 2007-03-06
- Last updated
- 2017-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.