Provider Demographics
NPI:1053155598
Name:CYRIAC, ANU NAVEEN (APRN)
Entity type:Individual
Prefix:MRS
First Name:ANU
Middle Name:NAVEEN
Last Name:CYRIAC
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ANU
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 DOROTHY DR
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-5711
Mailing Address - Country:US
Mailing Address - Phone:847-274-8784
Mailing Address - Fax:
Practice Address - Street 1:1950 W POLK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3723
Practice Address - Country:US
Practice Address - Phone:312-864-7000
Practice Address - Fax:312-864-9568
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.028608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine