Provider Demographics
NPI:1841240397
Name:BORDERS, ANN ELIZABETH BRYANT (MD, MPH, MSC)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:ELIZABETH BRYANT
Last Name:BORDERS
Suffix:
Gender:F
Credentials:MD, MPH, MSC
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:ELIZABETH
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:527 SOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3022
Mailing Address - Country:US
Mailing Address - Phone:847-570-4038
Mailing Address - Fax:
Practice Address - Street 1:2650 RIDGE AVE
Practice Address - Street 2:WALGREENS BUILDING, SUITE 1507
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1718
Practice Address - Country:US
Practice Address - Phone:847-570-4038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108814207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL336-069479OtherCONTROLLED SUBSTANCE
IL336-069479OtherCONTROLLED SUBSTANCE
IL036108814Medicare ID - Type Unspecified