Provider Demographics
NPI:1043469604
Name:CALLANAN, ANNE M
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:CALLANAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2877 VAIL CT.
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532
Mailing Address - Country:US
Mailing Address - Phone:630-369-7543
Mailing Address - Fax:
Practice Address - Street 1:27W 130 ROOSEVELT RD.
Practice Address - Street 2:SUITE 203
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1643
Practice Address - Country:US
Practice Address - Phone:630-588-8490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0110681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical