Provider Demographics
NPI:1861252330
Name:MENDEZ, ANNMARIE (MA)
Entity type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 SNOWBERRY CT
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1324
Mailing Address - Country:US
Mailing Address - Phone:630-728-7184
Mailing Address - Fax:
Practice Address - Street 1:700 E OGDEN AVE STE 304
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-5554
Practice Address - Country:US
Practice Address - Phone:630-828-2953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor