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Individual

ANNA ROY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
2331 W CHICAGO AVE, CHICAGO, IL 60622-4723
(773) 772-7858
Mailing address
PO BOX 3603, OAK BROOK, IL 60522-3603

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
041359915
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13543058
CAQH
IL
01
209011573
STATE LICENSE - ADVANCED PRACTICE NURSE
IL
01
A0513030
AANP - ADULT NURSE PRACTITIONER CERTIFICATION
01
QXIPQ0000181327
AETNA BETTER HEALTH
IL
Enumeration date
03/18/2015
Last updated
03/07/2023
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