Provider Demographics
NPI:1073860524
Name:THOMAS, ANU (APN-CNP)
Entity Type:Individual
Prefix:
First Name:ANU
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:PALLIATIVE CARE
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-503-4222
Mailing Address - Fax:847-982-4282
Practice Address - Street 1:2650 RIDGE AVE
Practice Address - Street 2:PALLIATIVE CARE
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1718
Practice Address - Country:US
Practice Address - Phone:847-503-4222
Practice Address - Fax:847-982-4282
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009604363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209009604OtherSTATE LICENSE