Provider Demographics
NPI:1548618549
Name:LIGGETT, ANNA BREEN (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:BREEN
Last Name:LIGGETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 N SAINT CLAIR ST STE 18-200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5929
Mailing Address - Country:US
Mailing Address - Phone:312-695-4525
Mailing Address - Fax:312-503-3350
Practice Address - Street 1:675 N SAINT CLAIR ST STE 18-200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5929
Practice Address - Country:US
Practice Address - Phone:312-695-4525
Practice Address - Fax:312-503-3350
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.149862207QG0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program