Provider Demographics
NPI:1467671263
Name:ANNA CLINIC CORP
Entity Type:Organization
Organization Name:ANNA CLINIC CORP
Other - Org Name:UNION COUNTY FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIRECTOR PHYSICIAN REV CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-3641
Mailing Address - Street 1:515 N MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:ANNA
Mailing Address - State:IL
Mailing Address - Zip Code:62906-1668
Mailing Address - Country:US
Mailing Address - Phone:618-833-2872
Mailing Address - Fax:618-833-2414
Practice Address - Street 1:515 N MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:ANNA
Practice Address - State:IL
Practice Address - Zip Code:62906-1668
Practice Address - Country:US
Practice Address - Phone:618-833-2872
Practice Address - Fax:618-833-2414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNA CLINIC CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-24
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214859Medicare PIN