Provider Demographics
NPI:1871769752
Name:ANTHONY, INGER (APN)
Entity type:Individual
Prefix:
First Name:INGER
Middle Name:
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
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Mailing Address - Street 1:840 S WOOD STREET
Mailing Address - Street 2:MC 856
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-996-7416
Mailing Address - Fax:312-996-8204
Practice Address - Street 1:1801 W TAYLOR STREET
Practice Address - Street 2:SUITE 2E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-996-7416
Practice Address - Fax:312-413-0243
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2016-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209005768363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics