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

Shorewood Family Medical Clinic SC

Organization Family Medicine Physician · NPI 1770644346

Shorewood Family Medical Clinic SC is a Family Medicine Physician in Kenosha, Wisconsin. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

4400 Sheridan Rd
Kenosha, WI 53140-5747
Phone: (262) 652-5454
Fax: (262) 652-5732
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1770644346
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Hubbard — President · (262) 652-5454
NPI enumeratedDecember 13, 2006
Last updated in NPPESAugust 22, 2020
Mailing address4400 Sheridan Rd, Kenosha, WI 53140-5747

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