Provider Demographics
NPI:1578588950
Name:KLOSINSKI, ANNE E (APN)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:E
Last Name:KLOSINSKI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5338 N SPAULDING AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-4722
Mailing Address - Country:US
Mailing Address - Phone:312-864-7890
Mailing Address - Fax:312-864-7394
Practice Address - Street 1:1900 W POLK ST
Practice Address - Street 2:1431
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3723
Practice Address - Country:US
Practice Address - Phone:312-864-7890
Practice Address - Fax:312-864-7394
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner