Provider Demographics
NPI:1639365661
Name:SILENZI, ANNA CK (DO)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CK
Last Name:SILENZI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:C
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:6308 8TH AVE
Mailing Address - Street 2:SUITE 3030
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53143-5031
Mailing Address - Country:US
Mailing Address - Phone:262-656-8895
Mailing Address - Fax:262-656-8898
Practice Address - Street 1:6308 8TH AVE
Practice Address - Street 2:SUITE 3030
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53143-5031
Practice Address - Country:US
Practice Address - Phone:262-656-8895
Practice Address - Fax:262-656-8898
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44086-021207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00449333OtherMEDICARE RR
WI43547000Medicaid
WIP00449333OtherMEDICARE RR