Provider Demographics
NPI:1386085330
Name:YOUNG, ANN STROUTS (PT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:STROUTS
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:LOUISE
Other - Last Name:STROUTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3828 N PAULINA ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2716
Mailing Address - Country:US
Mailing Address - Phone:480-427-6800
Mailing Address - Fax:
Practice Address - Street 1:3828 N PAULINA ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2716
Practice Address - Country:US
Practice Address - Phone:480-427-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-07
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10110225100000X
IL070.021121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist