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

Mr. William T Whalen IV, CO

Individual provider Prosthetic/Orthotic Supplier · NPI 1689091316

Mr. William T Whalen IV, CO is a Prosthetic/Orthotic Supplier in Kenosha, Wisconsin. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2014
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Practice location Address checks out

5027 Green Bay Rd Ste 124
Kenosha, WI 53144-1771
Phone: (262) 654-4300
Fax: (262) 654-4305
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetic/Orthotic Supplier (primary) Taxonomy 335E00000X · Licence 213000315 (IL)

Record details

NPI number1689091316
Entity typeIndividual (Type 1)
GenderMale
Credentials CO
Sole proprietorYes
NPI enumeratedMarch 19, 2014
Last updated in NPPESMarch 19, 2014

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