Organization
KENOSHA COMMUNITY HEALTH CENTER, INC.
Active
Parent organization
KENOSHA COMMUNITY HEALTH CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENOSHA COMMUNITY HEALTH CENTER, INC.
Authorized official
JOHN WILLIAM STAMPFL (CFO)
(262) 771-3561
Entity
Organization
Contact information
Practice address
930 DR MARTIN LUTHER KING DR # 3, RACINE, WI 53404-3008
(262) 656-0044
(262) 764-3636
Mailing address
4006 WASHINGTON RD, KENOSHA, WI 53144-4819
(262) 771-3561
(262) 764-3636
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100328514
—
WI
Enumeration date
06/16/2025
Last updated
02/25/2026
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