Individual
KENNETH GERARD GILBERTSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6815 118TH AVE, KENOSHA, WI 53142-8420
(262) 857-5600
(262) 857-1171
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
56044
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100017150
—
WI
01
—
P01084488
RR MEDICARE
WI
Enumeration date
07/08/2008
Last updated
10/01/2024
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