Healthcare Provider Details

I. General information

NPI: 1083327019
Provider Name (Legal Business Name): ANNA BRETSCHNEIDER PHD, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2023
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8311 ROOSEVELT RD
FOREST PARK IL
60130-2500
US

IV. Provider business mailing address

8311 ROOSEVELT RD
FOREST PARK IL
60130-2500
US

V. Phone/Fax

Practice location:
  • Phone: 708-771-7000
  • Fax:
Mailing address:
  • Phone: 708-771-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number277.003372
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: