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General NPI Number Information
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NPI Number | 1336526995
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Entity Type | Individual
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Provider Name | JOSHUA ANNEX
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Gender | Male
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Dates
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Enumeration Date | 05/04/2015
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 4007 N BROADWAY ST STE 204
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City | CHICAGO
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State | IL
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Zip | 60613-6076
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Country | US
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Telephone | 773-558-7029
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Fax |
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Provider Business Mailing Address
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Address Line | 1057 CARLYLE TER
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-4033
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Country | US
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Telephone | 917-520-1614
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.017410
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License Number State | IL
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