Provider Demographics
NPI:1720341035
Name:GARBULA, ANNA M (DPM)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:GARBULA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:M
Other - Last Name:CHRUPEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:30 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 720
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3402
Mailing Address - Country:US
Mailing Address - Phone:312-701-0770
Mailing Address - Fax:
Practice Address - Street 1:30 N MICHIGAN AVE
Practice Address - Street 2:SUITE 720
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3402
Practice Address - Country:US
Practice Address - Phone:312-701-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005581213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery