Provider Demographics
NPI:1154123321
Name:ULYANOV, ANNA (APRN)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:ULYANOV
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CENTRAL AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5615
Mailing Address - Country:US
Mailing Address - Phone:847-926-3225
Mailing Address - Fax:847-926-3225
Practice Address - Street 1:600 CENTRAL AVE STE 311
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5615
Practice Address - Country:US
Practice Address - Phone:847-926-3225
Practice Address - Fax:847-926-3225
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL377002661363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner