Provider Demographics
NPI:1770578114
Name:ENG, ANA M (MD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:M
Last Name:ENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:103 N HAVEN RD
Mailing Address - Street 2:STE 7
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2923
Mailing Address - Country:US
Mailing Address - Phone:630-832-2111
Mailing Address - Fax:630-832-5199
Practice Address - Street 1:103 N HAVEN RD
Practice Address - Street 2:SUITE #7
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2923
Practice Address - Country:US
Practice Address - Phone:630-832-2111
Practice Address - Fax:630-832-5199
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-044582207N00000X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL464210Medicare ID - Type Unspecified
ILD10991Medicare UPIN