Individual
DR. MARISSA LEA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1725 W HARRISON ST STE 1138, CHICAGO, IL 60612-3845
(312) 942-7088
Mailing address
1725 W HARRISON ST STE 1138, CHICAGO, IL 60612-3845
(312) 942-7088
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
262804
MA
208C00000X
Colon & Rectal Surgery Physician
Primary
036.161754
IL
208C00000X
Colon & Rectal Surgery Physician
83360
GA
390200000X
Student in an Organized Health Care Education/Training Program
BP10038035
TX
Other
Enumeration date
05/19/2010
Last updated
02/20/2023
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