| Organization Name: | IHC-KENOSHA RADIOLOGY, LLC |
| NPI Number: | 1225087224 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY A CIERLIK (PRESIDENT & CHIEF OPERATING OFFICER) |
| Mailing Address: | 9555 76th Street Uhs St Catherines Campus Pleasant Prairie |
| State: | WI US |
| Postal Code: | 531581984 |
| Phone Number: | 4142906720 |
| Fax Number: | 4142906755 |
| NPI Enumeration Date: | 05/08/2006 |
| NPI Last Update Date: | 10/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |