Individual
MR. ELIAS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
305 W JACKSON ST STE 206, CARBONDALE, IL 62901-1474
(618) 457-3006
(618) 457-3007
Mailing address
PO BOX 1467, INDIANAPOLIS, IN 46206-1467
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002820
IL
Other
Enumeration date
07/02/2007
Last updated
08/04/2025
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