Provider Demographics
NPI:1780820878
Name:THOMPSON, ANNA LEE
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LEE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:LEE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SOCIAL WORKER
Mailing Address - Street 1:1028 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-3967
Mailing Address - Country:US
Mailing Address - Phone:217-443-7005
Mailing Address - Fax:217-443-1384
Practice Address - Street 1:1028 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-3967
Practice Address - Country:US
Practice Address - Phone:217-443-7005
Practice Address - Fax:217-443-1384
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL66106241251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care