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Organization
CHILDREN'S HOSPITAL OF WISCONSIN, INC.
Active
Organization
CHILDREN'S HOSPITAL OF WISCONSIN, INC.
Active
Other names
Children's Hospital of Wisconsin, Inc. - Kenosha
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WELDON W GAGE (CFO/TREASURER)
(414) 266-6401
Entity
Organization
Contact information
Practice address
6308 8TH AVE, SIXTH FLOOR, KENOSHA, WI 53143-5031
(262) 656-2261
(262) 653-5751
Mailing address
PO BOX 1997, MILWAUKEE, WI 53201-1997
(414) 266-2000
(414) 266-6409
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
1003
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11023000
—
WI
Enumeration date
09/13/2006
Last updated
04/25/2013
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