Organization · Type 2 NPI
Kenosha Community Health Center, Inc.
Federally Qualified Health Center (FQHC) · Racine, WI
NPI number
1215823406
Active
Practice location
930 Dr Martin Luther King Dr # 3
Racine, WI 53404-3008
Fax (262) 764-3636
Mailing address
4006 Washington Rd
Kenosha, WI 53144-4819
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | None listed |
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
| Pediatric Nurse Practitioner | 363LP0200X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
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About NPI 1215823406
Kenosha Community Health Center, Inc.'s National Provider Identifier is 1215823406, issued on Jun 16, 2025. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Racine, WI. The record was last updated on Feb 25, 2026.