Individual
DR. ANDERS MELLGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 W TAYLOR ST, 3F OCC, CHICAGO, IL 60612-4795
(312) 355-4300
(312) 413-1206
Mailing address
840 S WOOD ST, SUITE 518 CSB - MC 957, CHICAGO, IL 60612-4325
(312) 996-2061
(312) 996-1214
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
036.133002
IL
208C00000X
Colon & Rectal Surgery Physician
45364
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036.133002
—
IL
05
—
764487600
—
MN
Enumeration date
08/05/2006
Last updated
07/08/2016
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