Provider Demographics
NPI:1447638887
Name:ALTGILBERS, ANN M (APRN)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:ALTGILBERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 VADALABENE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-5839
Mailing Address - Country:US
Mailing Address - Phone:618-288-4350
Mailing Address - Fax:618-288-4296
Practice Address - Street 1:2133 VADALABENE DR STE 1
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-5839
Practice Address - Country:US
Practice Address - Phone:618-288-4350
Practice Address - Fax:618-288-4296
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.012774363LF0000X
IL277001249363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily