Provider Demographics
NPI:1427420967
Name:CHAVEZ, ANNA MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIE
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26W171 ROOSEVELT RD.
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187
Mailing Address - Country:US
Mailing Address - Phone:630-909-8000
Mailing Address - Fax:630-909-8438
Practice Address - Street 1:26W171 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-6002
Practice Address - Country:US
Practice Address - Phone:630-909-6148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42773225100000X
IL070021856225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist