Individual
ANDRE IVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 S HIGHLAND AVE STE 220, LOMBARD, IL 60148-4932
(630) 790-1872
(630) 873-8812
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
125-058363
IL
Other
Enumeration date
06/25/2010
Last updated
08/08/2023
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