Healthcare Provider Details

I. General information

NPI: 1063787398
Provider Name (Legal Business Name): ANA CLAUDIA TADDEI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANA CLAUDIA DE CASTRO CARRAZEDO TADDEI M.D.

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE
EVANSTON IL
60201-1700
US

IV. Provider business mailing address

2650 RIDGE AVE STE 150
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2530
  • Fax: 847-570-0231
Mailing address:
  • Phone: 847-982-6715
  • Fax: 847-982-3394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036139314
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number036139314
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: