Diane Anzelde

Individual provider Active NPI Driver · Schaumburg, IL

NPI 1437334802 · NPPES record last updated Jan 4, 2008

Key facts

NPI
1437334802
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
A524-1734-4921 (IL)
Practice address
2548 Crooked Creek Rd
204
Schaumburg, IL 60173-5599
Phone
(847) 397-8497
NPI assigned
Jan 4, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A524-1734-4921ILMDDriver

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X A524-1734-4921 IL Yes

Addresses

Primary practice location

2548 Crooked Creek Rd
204
Schaumburg, IL 60173-5599

Mailing address

2548 Crooked Creek Rd
204
Schaumburg, IL 60173-5599
Phone (847) 397-8497

Other providers in Schaumburg, IL

All providers in Schaumburg, IL · Driver in Illinois

Sources for this page

Verify at the official NPI Registry.