Provider Demographics
NPI:1053938571
Name:DEGRASSI-KALKIS, ANNA MARIA (L AC, DIPL OM)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:DEGRASSI-KALKIS
Suffix:
Gender:F
Credentials:L AC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20801 S HUMBOLDT DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-9079
Mailing Address - Country:US
Mailing Address - Phone:815-955-2893
Mailing Address - Fax:
Practice Address - Street 1:18700 WOLF RD STE 211
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8603
Practice Address - Country:US
Practice Address - Phone:815-955-2893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000654171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist