Provider Demographics
NPI:1588057814
Name:RAIMONDI, ANNA M (APN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:RAIMONDI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 CARLISLE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60554-9805
Mailing Address - Country:US
Mailing Address - Phone:630-466-8909
Mailing Address - Fax:
Practice Address - Street 1:602 CARLISLE CT
Practice Address - Street 2:
Practice Address - City:SUGAR GROVE
Practice Address - State:IL
Practice Address - Zip Code:60554-9805
Practice Address - Country:US
Practice Address - Phone:630-466-8909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.012555363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care