Individual
MRS. ANNE ELIZABETH TAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-4700
(630) 933-4427
Mailing address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-4700
(630) 933-4427
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209006006
IL
363LA2200X
Adult Health Nurse Practitioner
209006006
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147129
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
CA4748
MEDICARE RAILROAD GROUP PTAN
IL
01
—
P01398559
MEDICARE RAILROAD
IL
Enumeration date
07/25/2007
Last updated
02/24/2015
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