Provider Demographics
NPI:1891743035
Name:HUG, ANN (MPT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:HUG
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 N ILLINOIS ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-3419
Mailing Address - Country:US
Mailing Address - Phone:618-253-4357
Mailing Address - Fax:618-235-9865
Practice Address - Street 1:5007 N ILLINOIS ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-3419
Practice Address - Country:US
Practice Address - Phone:618-253-4357
Practice Address - Fax:618-235-9865
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211689Medicare ID - Type Unspecified
ILP98539Medicare UPIN