Healthcare Provider Details

I. General information

NPI: 1083934442
Provider Name (Legal Business Name): ANNE MARIE ELIZABETH DRAHOS MSN, APN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3040 W SALT CREEK LN
ARLINGTON HEIGHTS IL
60005-1069
US

IV. Provider business mailing address

701 S CARPENTER ST UNIT D
CHICAGO IL
60607-3471
US

V. Phone/Fax

Practice location:
  • Phone: 847-483-7043
  • Fax:
Mailing address:
  • Phone: 312-243-2559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number209008051
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: