Individual
DR. ANDREW J. BARTLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1801 W WINDSOR RD, CHAMPAIGN, IL 61822-6217
(217) 366-5434
(217) 366-8074
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-5434
(217) 366-8074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-109829
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361098929 1
—
IL
01
—
279500
MEDICARE GROUP
IL
01
—
P00062056
RAILROAD MEDICARE
IL
Enumeration date
08/01/2006
Last updated
01/05/2022
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