Provider Demographics
NPI:1962770792
Name:VALLEY, ANNE ELIZABETH
Entity type:Individual
Prefix:MISS
First Name:ANNE
Middle Name:ELIZABETH
Last Name:VALLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 N COLUMBUS DR
Mailing Address - Street 2:APT 4509
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7810
Mailing Address - Country:US
Mailing Address - Phone:630-947-5173
Mailing Address - Fax:
Practice Address - Street 1:222 N COLUMBUS DR
Practice Address - Street 2:APT 4509
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7810
Practice Address - Country:US
Practice Address - Phone:630-947-5173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program