Healthcare Provider Details

I. General information

NPI: 1295887321
Provider Name (Legal Business Name): V. STEPHEN SLANA , M.D.,S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6125 GREEN BAY RD SUITE 800
KENOSHA WI
53142-2928
US

IV. Provider business mailing address

6125 GREEN BAY RD STE 800
KENOSHA WI
53142-2982
US

V. Phone/Fax

Practice location:
  • Phone: 262-654-0726
  • Fax: 262-654-4365
Mailing address:
  • Phone: 262-654-0726
  • Fax: 262-654-4365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: VICTOR STEPHEN SLANA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 262-654-0726