Healthcare Provider Details

I. General information

NPI: 1932030012
Provider Name (Legal Business Name): ANCHOR & EDGE THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2069 WILLIAM DR
MONTGOMERY IL
60538-6005
US

IV. Provider business mailing address

980 N MICHIGAN AVE STE 1090
CHICAGO IL
60611-4521
US

V. Phone/Fax

Practice location:
  • Phone: 815-556-2097
  • Fax:
Mailing address:
  • Phone: 815-556-2097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AMELIA BARONE
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 815-556-2097