Individual
KENNETH P WIND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8000
(262) 577-8869
Mailing address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8000
(262) 577-8869
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
036092923
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
38946
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621061
BCBS IL
IL
05
—
036092923
—
IL
05
—
1306985544
—
WI
01
—
132302200
DEPARTMENT OF LABOR
—
01
—
220023765
RAILROAD MEDICARE
—
Enumeration date
02/05/2007
Last updated
12/23/2020
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