Individual
ANNE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
472 ROUTE 47, SUGAR GROVE, IL 60554-8107
(630) 466-6000
Mailing address
1256 WATERFORD DR STE 230, AURORA, IL 60504-4511
(630) 978-6204
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209023170
IL
363L00000X
Nurse Practitioner
R171561
MD
363L00000X
Nurse Practitioner
SP006072B
PA
363LF0000X
Family Nurse Practitioner
Primary
209023170
IL
363LF0000X
Family Nurse Practitioner
333962
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1589494
GATEWAY MEDICARE ASSURED-WMG
PA
01
—
2512931
HIGHMARK BLUE SHIELD-WMG
PA
Enumeration date
07/25/2006
Last updated
03/16/2023
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