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

Individual provider Family Medicine Physician · NPI 1104127372

Rodrigo A Mata Jr., MD is a Family Medicine Physician in Kenosha, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

6123 Green Bay Rd Ste 120
Kenosha, WI 53142-2927
Phone: (262) 652-6995
Fax: (262) 652-1370
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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 · Licence 22023-20 (WI)

Record details

NPI number1104127372
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedNovember 4, 2010
Last updated in NPPESNovember 4, 2010

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