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

Surgical Associates of Kenosha, SC

Organization Surgery Physician · NPI 1417222076

Surgical Associates of Kenosha, SC is a Surgery Physician in Kenosha, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2012.

Licensed in
WI
In the registry since
2012

Practice location Address checks out

6308 8th Ave Ste 302
Kenosha, WI 53143-5031
Phone: (262) 656-8217
Show map & directions

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

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 16095 (WI)

Record details

NPI number1417222076
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roger Pacanowski — President · (262) 652-5370
NPI enumeratedMarch 15, 2012
Last updated in NPPESMarch 15, 2012
Mailing address7600 2nd Ave, Kenosha, WI 53143-6067

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