Provider Demographics
NPI:1033871256
Name:LESTER & ROSALIE ANIXTER CENTER
Entity Type:Organization
Organization Name:LESTER & ROSALIE ANIXTER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLAIMS ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-697-6529
Mailing Address - Street 1:6610 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-4062
Mailing Address - Country:US
Mailing Address - Phone:773-697-6529
Mailing Address - Fax:312-312-9607
Practice Address - Street 1:6610 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-4062
Practice Address - Country:US
Practice Address - Phone:773-697-6529
Practice Address - Fax:312-312-9607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)