Healthcare Provider Details

I. General information

NPI: 1013121177
Provider Name (Legal Business Name): ANN M HARVEY APN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANN HARVEY SPEVACEK APN, CNP, DNP

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 W WELLINGTON AVE
CHICAGO IL
60657-5147
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-1293
US

V. Phone/Fax

Practice location:
  • Phone: 773-296-3646
  • Fax: 773-296-7289
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209002533
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041-215814
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: