Healthcare Provider Details

I. General information

NPI: 1740103456
Provider Name (Legal Business Name): TAYLOR ANNE CANITZ DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2762 N LINCOLN AVE STE C
CHICAGO IL
60614-2425
US

IV. Provider business mailing address

1253 W NEWPORT AVE APT G
CHICAGO IL
60657-8384
US

V. Phone/Fax

Practice location:
  • Phone: 224-273-5780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: