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General NPI Number Information
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NPI Number | 1679607196
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Entity Type | Individual
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Provider Name | ANNIE LAMORENA CALLANGAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4753 N ELSTON AVE
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City | CHICAGO
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State | IL
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Zip | 60630-4002
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Country | US
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Telephone | 773-989-3845
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Fax | 773-989-1673
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Provider Business Mailing Address
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Address Line | 6427 N KENTON AVE
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-3414
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Country | US
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Telephone | 847-677-2445
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Fax | 773-989-1673
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | IL
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