Provider Demographics
NPI:1891463220
Name:LODEWYCK, ANNE MARIE (FNP, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANNE MARIE
Middle Name:
Last Name:LODEWYCK
Suffix:
Gender:F
Credentials:FNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-2102
Mailing Address - Country:US
Mailing Address - Phone:847-836-5202
Mailing Address - Fax:630-300-3702
Practice Address - Street 1:754 S 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-2102
Practice Address - Country:US
Practice Address - Phone:847-836-5202
Practice Address - Fax:847-836-5209
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.023864363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty