| Doctor Name: | MRS. ANITHA PHILIP |
| NPI Number: | 1558575779 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 209006614 |
| Business Practice Address: | 501 Beach Ave La Grange Park, IL - 605265715 |
| Business Phone Number: | 3124047713 |
| Business Fax Number: | |
| Mailing Address: | 501 Beach Ave, LA GRANGE PARK |
| State: | IL |
| Postal Code: | 605265715 |
| Phone Number: | 3124047713 |
| Fax Number: | |
| NPI Enumeration Date: | 05/09/2007 |
| NPI Last Update Date: | 07/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209006614 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |