Basic Information
| Provider Information | |||||||||
| NPI: | 1154642494 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TYSON | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | FRANCES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., M.P.H. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9650 GROSS POINT RD STE 3900 | ||||||||
| Address2: | |||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600765085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475701700 | ||||||||
| FaxNumber: | 8479821098 | ||||||||
| Practice Location | |||||||||
| Address1: | 9650 GROSS POINT RD STE 3900 | ||||||||
| Address2: | |||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600765085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475701700 | ||||||||
| FaxNumber: | 8479821098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2010 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 165778 | NC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208600000X | 036.143263 | IL | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.