Individual
ANNA DE LA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 329-1000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125059545
IL
208M00000X
Hospitalist Physician
Primary
62390-20
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100038124
—
WI
Enumeration date
08/10/2011
Last updated
05/08/2025
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