Provider Demographics
NPI:1851431514
Name:NIEHUES, ANITA NELSON (MS,OTR)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:NELSON
Last Name:NIEHUES
Suffix:
Gender:F
Credentials:MS,OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 LIN LOR LN
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5085
Mailing Address - Country:US
Mailing Address - Phone:847-695-1677
Mailing Address - Fax:
Practice Address - Street 1:245 W EXCHANGE ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-1495
Practice Address - Country:US
Practice Address - Phone:815-895-9227
Practice Address - Fax:815-895-2971
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist