Healthcare Provider Details

I. General information

NPI: 1992641229
Provider Name (Legal Business Name): LUANDA ISIS ANOKYE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6120 W HARRISON STREET
CHICAGO IL
60612
US

IV. Provider business mailing address

6120 W HARRISON STREET
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-5000
  • Fax:
Mailing address:
  • Phone: 312-942-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.577271
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: