Healthcare Provider Details

I. General information

NPI: 1538088380
Provider Name (Legal Business Name): ERIN ANTHONY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E BUSSE AVE
MOUNT PROSPECT IL
60056-3215
US

IV. Provider business mailing address

70 E BUSSE AVE
MOUNT PROSPECT IL
60056-3215
US

V. Phone/Fax

Practice location:
  • Phone: 847-749-4408
  • Fax: 847-749-3658
Mailing address:
  • Phone: 847-749-4408
  • Fax: 847-749-3658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209036106
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: