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General NPI Number Information
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NPI Number | 1134328123
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Entity Type | Organization
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Legal Business Name | ANCHOR PEDIATRICS
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 550 N MIDLOTHIAN RD SUITE 400
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City | MUNDELEIN
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State | IL
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Zip | 60060-1613
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Country | US
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Telephone | 847-837-1923
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Fax | 847-837-1924
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Provider Business Mailing Address
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Address Line | 550 N MIDLOTHIAN RD SUITE 400
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City | MUNDELEIN
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State | IL
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Zip | 60060-1613
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Country | US
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Telephone | 847-837-1923
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Fax | 847-837-1924
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SHEBA A ANTONY
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Credential | M.D
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Telephone | 847-837-1923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | IL
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