Individual
ANDREW JAMES STANDEFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7311
Mailing address
1206 MORELAND CT, MORO, IL 62067-1559
(618) 210-1594
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.448411
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209.021339
IL
Other
Enumeration date
05/19/2020
Last updated
05/25/2022
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