Provider Demographics
NPI:1174515035
Name:IYER, ANITA (MD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:IYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9730 S WESTERN AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2814
Mailing Address - Country:US
Mailing Address - Phone:708-425-1907
Mailing Address - Fax:708-422-4253
Practice Address - Street 1:9730 S WESTERN AVE
Practice Address - Street 2:STE 100
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2814
Practice Address - Country:US
Practice Address - Phone:708-425-1907
Practice Address - Fax:708-422-4253
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH94105Medicare UPIN
ILK01009Medicare ID - Type Unspecified