Basic Information
| Provider Information | |||||||||
| NPI: | 1588892277 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GURRERA | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | CHRISTINE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 765 ELA RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | LAKE ZURICH | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600472339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475409949 | ||||||||
| FaxNumber: | 8475409971 | ||||||||
| Practice Location | |||||||||
| Address1: | 765 ELA RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LAKE ZURICH | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600472385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475409949 | ||||||||
| FaxNumber: | 8475409971 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2009 | ||||||||
| LastUpdateDate: | 12/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | 135000692 | IL | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.