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Organization
AURORA HEALTH CARE SOUTHERN LAKES, INC.
Active
Organization
AURORA HEALTH CARE SOUTHERN LAKES, INC.
Active
Other names
Aurora Medical Center Kenosha
Organization subpart
No
Provider details
NPI number
Authorized official
KARA RICHARDSON (VP MANAGED HEEALTH)
(704) 631-0450
Entity
Organization
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142
(262) 942-5600
Mailing address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 942-5600
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207U00000X
Nuclear Medicine Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
208600000X
Surgery Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11022500
—
WI
05
—
41224100
—
WI
05
—
41565500
—
WI
05
—
41759000
—
WI
Enumeration date
03/26/2007
Last updated
10/01/2025
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