Individual
DR. CHARLES SANTILUKKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1020 35TH ST, SUITE 160, KENOSHA, WI 53140-1932
(262) 652-3500
Mailing address
1020 35TH ST, SUITE 160, KENOSHA, WI 53140-1932
(262) 652-3500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
61037-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100031358
—
WI
Enumeration date
04/10/2012
Last updated
10/06/2022
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