Provider Demographics
NPI:1780976399
Name:JEONG, ANNA B (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:B
Last Name:JEONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:225 E CHICAGO AVE
Mailing Address - Street 2:BOX 29
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2991
Mailing Address - Country:US
Mailing Address - Phone:312-227-3540
Mailing Address - Fax:312-227-9644
Practice Address - Street 1:225 E CHICAGO AVE
Practice Address - Street 2:BOX 29
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-3540
Practice Address - Fax:312-227-9644
Is Sole Proprietor?:No
Enumeration Date:2011-05-15
Last Update Date:2017-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL0361417202084N0402X
MO20140240662084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology