MR. WILLIAM T WHALEN IV C.O. - NPI 1689091316 - Prosthetic/Orthotic Supplier in Kenosha, WI

Q: What is the provider's specialty?

The provider's specialty is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

On this page

About Mr. William T Whalen Iv C.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. WILLIAM T WHALEN IV C.O. (NPI 1689091316) is an individual prosthetic/orthotic supplier provider in Kenosha, Wisconsin, licensed in Illinois (213000315) and active in the NPI registry since March 2014.

NPPES Registry Identity

NPI1689091316

Entity TypeIndividualMale

Primary Taxonomy335E00000X

Provider Legal NameMR. WILLIAM T WHALEN IVCredential: C.O.

Location Address5027 GREEN BAY RD, SUITE 124Kenosha, WI 53144-1771

Mailing Address5027 Green Bay Rd, Suite 124Kenosha, WI 53144-1771 · (262) 654-4300 · Fax (262) 654-4305

Phone(262) 654-4300

Fax(262) 654-4305

Sole ProprietorYes

Enumeration DateMarch 19, 2014

✔ NPI 1689091316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers

Taxonomy Code335E00000X

License✔ Licensed in IL · 213000315

Definition

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

5027 GREEN BAY RD, Kenosha, WI 53144

Open in Google Maps ↗