Ahamed Ali, LPN

Individual provider Active NPI Licensed Practical Nurse · Kenosha, WI

NPI 1922935501 · NPPES record last updated May 6, 2026

Key facts

NPI
1922935501
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
307970 (WI)
Practice address
3825 39TH Ave Ste 120
Kenosha, WI 53144-2043
Phone
(262) 946-5752
Fax
(262) 946-5765
NPI assigned
May 6, 2026
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
307970WIMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Addiction Services and Pharmacotherapy, SC Past
since Jan 21, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 307970 WI Yes

Addresses

Primary practice location

3825 39TH Ave Ste 120
Kenosha, WI 53144-2043

Mailing address

3825 39TH Ave Ste 120
Kenosha, WI 53144-2043
Phone (262) 946-5752

Other providers in Kenosha, WI

All providers in Kenosha, WI · Licensed Practical Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.