Provider Demographics
NPI:1578114427
Name:DEVAR, ANN ROBINSON
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:ROBINSON
Last Name:DEVAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 THELIN CT
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4038
Mailing Address - Country:US
Mailing Address - Phone:847-814-2954
Mailing Address - Fax:
Practice Address - Street 1:1605 THELIN CT
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4038
Practice Address - Country:US
Practice Address - Phone:847-814-2954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
IL1-20-44437103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician