Provider Demographics
NPI:1053855015
Name:ZAHORA, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ZAHORA
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 1:762 DEMPSTER ST APT D212
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6153
Mailing Address - Country:US
Mailing Address - Phone:224-425-9535
Mailing Address - Fax:
Practice Address - Street 1:762 DEMPSTER ST APT D212
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-6153
Practice Address - Country:US
Practice Address - Phone:224-425-9535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-10
Last Update Date:2016-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer