Provider Demographics
NPI:1083934442
Name:DRAHOS, ANNE MARIE ELIZABETH (MSN, APN, CPNP)
Entity Type:Individual
Prefix:MS
First Name:ANNE MARIE
Middle Name:ELIZABETH
Last Name:DRAHOS
Suffix:
Gender:F
Credentials:MSN, APN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S CARPENTER ST UNIT D
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3471
Mailing Address - Country:US
Mailing Address - Phone:312-243-2559
Mailing Address - Fax:
Practice Address - Street 1:3040 W SALT CREEK LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1069
Practice Address - Country:US
Practice Address - Phone:847-483-7043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008051363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics