MEDICARE: MRS. ANNA ROHAN HEALY P.A.

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	363A00000X	Physician Assistant	085003912	IL

General Provider Information

NPI Number	:	1881994002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNA ROHAN HEALY P.A.

Provider Business Mailing Address
First Line	:	2775 SANDERS RD STE C1
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-6110
Country	:	US
Telephone Number	:	847-402-2300
Fax Number	:	847-402-2600

Provider Business Practice Location Address
First Line	:	2775 SANDERS RD STE C1
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-6110
Country	:	US
Telephone Number	:	847-402-2300
Fax Number	:	847-402-2600

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

Provider Enumeration Date	:	10/22/2010
Last Update Date	:	04/09/2019

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