Provider Demographics
NPI:1134328123
Name:ANCHOR PEDIATRICS
Entity Type:Organization
Organization Name:ANCHOR PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEBA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANTONY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-837-1923
Mailing Address - Street 1:550 N MIDLOTHIAN RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1613
Mailing Address - Country:US
Mailing Address - Phone:847-837-1923
Mailing Address - Fax:847-837-1924
Practice Address - Street 1:550 N MIDLOTHIAN RD
Practice Address - Street 2:SUITE 400
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-1613
Practice Address - Country:US
Practice Address - Phone:847-837-1923
Practice Address - Fax:847-837-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty