Individual
DR. BETTE L ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3015 VILLAGE OFFICE PL, CHAMPAIGN, IL 61822-7674
(217) 355-7947
(217) 355-8047
Mailing address
3015 VILLAGE OFFICE PL, CHAMPAIGN, IL 61822-7674
(217) 355-7947
(217) 355-8047
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036073436
IL
207W00000X
Ophthalmology Physician
BA0383757
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036073436
—
IL
01
—
1032096
BLUE CROSS BLUE SHIELD
IL
01
—
205022193
TRI-CARE
IL
01
—
301724
PERSONAL CARE
IL
01
—
960582
UNITED HEALTHCARE
IL
Enumeration date
03/09/2006
Last updated
03/28/2018
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