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Individual

DR. ANANYA T. SPANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
16660 S. 107TH AVE., ORLAND PARK, IL 60467-8898
(708) 403-8500
(708) 364-7080
Mailing address
16660 S. 107TH AVE., ORLAND PARK, IL 60467-8898
(708) 403-8500
(708) 364-7080

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01630151
BCBS PROVIDER GROUP #
IL
01
5069397
AETNA PROVIDER ID#
IL
Enumeration date
07/27/2006
Last updated
07/08/2007
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