Individual
DR. JOHN ALEXANDER JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6815 118TH AVE, KENOSHA, WI 53142-8420
(262) 857-5600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3312
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100031400
MEDICAID LEGACY NUMBER
WI
05
—
100031400
—
WI
Enumeration date
05/28/2013
Last updated
07/06/2026
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