MEDICARE: DR. ANNE MAXWELL SEIDEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	036040178	IL
2	2084P0802X	Addiction Psychiatry Physician	036040178	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306939640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE MAXWELL SEIDEN M.D.

Provider Business Mailing Address
First Line	:	5544 S WOODLAWN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1621
Country	:	US
Telephone Number	:	773-241-7072
Fax Number	:	773-643-6058

Provider Business Practice Location Address
First Line	:	5544 S WOODLAWN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1621
Country	:	US
Telephone Number	:	773-241-7072
Fax Number	:	773-643-6058

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2006
Last Update Date	:	03/16/2010

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