Provider Demographics
NPI:1689011157
Name:WU, ANNA CHRISTINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:CHRISTINE
Last Name:WU
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 1:3235 W ADDISON ST STE B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4328
Mailing Address - Country:US
Mailing Address - Phone:443-465-5046
Mailing Address - Fax:
Practice Address - Street 1:3235 W ADDISON ST STE B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4328
Practice Address - Country:US
Practice Address - Phone:443-465-5046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029524122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist