MEDICARE: DR. ANNA A STANISLAUS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	036121612	IL

General Provider Information

NPI Number	:	1699921353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA A STANISLAUS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 713260
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-1260
Country	:	US
Telephone Number	:	630-469-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 N CASS AVE STE 150
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-1121
Country	:	US
Telephone Number	:	630-268-0200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2008
Last Update Date	:	09/06/2023

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Directions to “ DR. ANNA A STANISLAUS M.D.” Practice Location

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