Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Genesis Medical Center of Kenosha, SC

Organization Family Medicine Physician · NPI 1063456424

Genesis Medical Center of Kenosha, SC is a Family Medicine Physician in Kenosha, Wisconsin. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3

Practice location Address checks out

1020 35th St
Kenosha, WI 53140-1902
Phone: (262) 652-3500
Fax: (262) 925-8353
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
Rheumatology Physician Taxonomy 207RR0500X

Record details

NPI number1063456424
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jean Garretto — Office Manager · (262) 652-3500
NPI enumeratedJune 16, 2006
Last updated in NPPESApril 20, 2008
Mailing address1020 35th St, Kenosha, WI 53140-1902

Other providers in Kenosha