Provider Demographics
NPI:1881807147
Name:BYRNES, ANNE MARIE (AUD)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:BYRNES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:BEHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1417 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002
Mailing Address - Country:US
Mailing Address - Phone:618-462-7900
Mailing Address - Fax:618-462-0179
Practice Address - Street 1:1417 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002
Practice Address - Country:US
Practice Address - Phone:618-462-7900
Practice Address - Fax:618-462-0179
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147001189237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213815001Medicare PIN