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Individual
MR. DEAN CHARLES ANDERSON
Active
Individual
MR. DEAN CHARLES ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, PT, CERT. MDT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.011395
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
364526905
TAX ID#
IL
01
—
560898
HEALTHLINK PROVIDER ID#
IL
01
—
8432060
BCBS PROVIDER ID #
IL
Enumeration date
03/16/2007
Last updated
07/08/2007
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