Provider Demographics
NPI:1164717278
Name:MCCORMICK KRAJEWSKI, ANNA C (DO)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:C
Last Name:MCCORMICK KRAJEWSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:C
Other - Last Name:MCCORMICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1725 W HARRISON ST
Mailing Address - Street 2:STE 408
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3852
Mailing Address - Country:US
Mailing Address - Phone:312-942-8020
Mailing Address - Fax:312-942-8222
Practice Address - Street 1:1645 W JACKSON BLVD STE 310
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3227
Practice Address - Country:US
Practice Address - Phone:312-942-8020
Practice Address - Fax:312-942-8222
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI64211207V00000X, 207VM0101X
IL125-059256207V00000X
IL036-145393207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology