Provider Demographics
NPI:1639800584
Name:MCDEVITT, ANNA EILEEN (DDS)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:EILEEN
Last Name:MCDEVITT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 N WABASH AVE APT 2207
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2280
Mailing Address - Country:US
Mailing Address - Phone:734-363-4444
Mailing Address - Fax:
Practice Address - Street 1:33 N DEARBORN ST STE 2400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3109
Practice Address - Country:US
Practice Address - Phone:773-906-7255
Practice Address - Fax:630-423-9646
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.033695122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist