Individual
ANNE T CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 HENRY LUCKOW LN, BELVIDERE, IL 61008-1702
(779) 696-8650
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041322939
IL
363LF0000X
Family Nurse Practitioner
Primary
209016514
IL
Other
Enumeration date
05/22/2017
Last updated
03/17/2021
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