Individual
SCOTT F KENITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1640 E SUMNER ST, HARTFORD, WI 53027
(262) 670-4000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1739
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38513700
—
WI
01
—
P00941476
RR MEDICARE
WI
Enumeration date
07/25/2006
Last updated
08/25/2025
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