Provider Demographics
NPI:1689231144
Name:BARR, ANNEMARIE ELISE (APRN)
Entity Type:Individual
Prefix:DR
First Name:ANNEMARIE
Middle Name:ELISE
Last Name:BARR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANNEMARIE
Other - Middle Name:
Other - Last Name:BLITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2800 N LAKE SHORE DR APT 1114
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6258
Mailing Address - Country:US
Mailing Address - Phone:317-850-6045
Mailing Address - Fax:
Practice Address - Street 1:1775 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1143
Practice Address - Country:US
Practice Address - Phone:847-723-2210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019184363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care