Healthcare Provider Details

I. General information

NPI: 1063534592
Provider Name (Legal Business Name): ANNE POWERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

371-4 SANDHURST CIRCLE
GLEN ELLYN IL
60137-6663
US

IV. Provider business mailing address

371-4 SANDHURST CIRCLE
GLEN ELLYN IL
60137-6663
US

V. Phone/Fax

Practice location:
  • Phone: 630-858-5220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.026553
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: