Provider Demographics
NPI:1861677049
Name:PARKER, ANNE THERESE
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:THERESE
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 NEWBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-1252
Mailing Address - Country:US
Mailing Address - Phone:708-482-9228
Mailing Address - Fax:
Practice Address - Street 1:1217 NEWBERRY AVE
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-1252
Practice Address - Country:US
Practice Address - Phone:708-482-9228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist