Healthcare Provider Details

I. General information

NPI: 1871661686
Provider Name (Legal Business Name): KENNETH SILVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE MC 3055 UNIVERSITY OF CHICAGO HOSPITALS & CLINICS
CHICAGO IL
60637
US

IV. Provider business mailing address

5841 S MARYLAND AVE MC 3055 UNIVERSITY OF CHICAGO HOSPITALS & CLINICS
CHICAGO IL
60637
US

V. Phone/Fax

Practice location:
  • Phone: 773-702-6487
  • Fax: 773-702-4786
Mailing address:
  • Phone: 773-702-6487
  • Fax: 773-702-4786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number036-094697
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: