Provider Demographics
NPI:1245095116
Name:SCHEELE, ANNA GLENDA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:GLENDA
Last Name:SCHEELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:GLENN
Other - Last Name:SCHEELE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1025 BRADFORD LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2607
Mailing Address - Country:US
Mailing Address - Phone:224-236-2932
Mailing Address - Fax:
Practice Address - Street 1:1025 BRADFORD LN
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-2607
Practice Address - Country:US
Practice Address - Phone:224-236-2932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician