Allergy & Asthma Clinic of Kenosha SC

Organization Active NPI Medical Specialty Clinic/Center · Kenosha, WI

NPI 1649202128 · NPPES record last updated Nov 7, 2008

Key facts

NPI
1649202128
Entity type
Organization (NPI type 2)
Primary specialty
Medical Specialty Clinic/Center 261QM2500X
Legal business name
ALLERGY & ASTHMA CLINIC OF KENOSHA SC
Practice address
4906 39TH Ave
Kenosha, WI 53144-2108
Phone
(262) 657-9390
Fax
(262) 657-4666
NPI assigned
Jul 7, 2006
Organization subpart
No

Authorized official

Name
Dr. Kulwant Singh Dhaliwal, MD
Title
President
Phone
(262) 657-9390

National Provider Directory

Locations

4906 39th Ave
Kenosha, WI 53144
Phone (262) 657-4666

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X WI Yes

Addresses

Primary practice location

4906 39TH Ave
Kenosha, WI 53144-2108

Mailing address

4906 39TH Ave
Kenosha, WI 53144-2108
Phone (262) 657-9390

Other identifiers

IdentifierTypeStateIssuer
32656900MedicaidWI

Other providers in Kenosha, WI

All providers in Kenosha, WI · Medical Specialty Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.