Provider Demographics
NPI:1720339773
Name:STRONG, ANNA MEHLHOP (LAC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MEHLHOP
Last Name:STRONG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 S OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-2090
Mailing Address - Country:US
Mailing Address - Phone:312-402-2296
Mailing Address - Fax:
Practice Address - Street 1:503 MADISON ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4435
Practice Address - Country:US
Practice Address - Phone:708-848-4626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-29
Last Update Date:2012-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000972171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist