Provider Demographics
NPI:1548486327
Name:ANTON, DIANA SUSAN (APN)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:SUSAN
Last Name:ANTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:SUSAN
Other - Last Name:KAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4201 WINFIELD RD FL 4
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-4025
Mailing Address - Country:US
Mailing Address - Phone:331-221-6377
Mailing Address - Fax:331-221-2357
Practice Address - Street 1:1200 S YORK ST
Practice Address - Street 2:STE 2000
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126
Practice Address - Country:US
Practice Address - Phone:331-221-9001
Practice Address - Fax:331-221-3936
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.004129363LA2200X
IL209-0004129363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health