Individual
KATHY ANN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2240 GATEWAY DR, SYCAMORE, IL 60178
(815) 756-8571
(815) 756-1790
Mailing address
2240 GATEWAY DR, SYCAMORE, IL 60178
(815) 756-8571
(815) 756-1790
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036071921
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036071921
—
IL
01
—
L71596
MEDICARE
IL
Enumeration date
03/23/2006
Last updated
03/27/2008
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