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General NPI Number Information
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NPI Number | 1902310006
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Entity Type | Individual
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Provider Name | MARIA ANNUM OD
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Gender | Female
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 4931 S ROUTE 59 STE 115
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City | NAPERVILLE
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State | IL
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Zip | 60564-2692
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Country | US
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Telephone | 630-904-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 3462 55TH ST NW STE 600
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City | ROCHESTER
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State | MN
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Zip | 55901-0203
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Country | US
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Telephone |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2005-951AT
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODP-100568
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12692184-9934
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3542
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046011272
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License Number State | IL
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