Organization
JOEL R. ANDERSON, PC
Active
Other names
Advanced Foot & Ankle Centers of Illinois
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL R ANDERSON D.P.M. (OWNER)
(773) 736-3338
Entity
Organization
Contact information
Practice address
4920 N CENTRAL AVE, STE 1A, CHICAGO, IL 60630-2338
(773) 736-3338
(773) 736-1289
Mailing address
4920 N CENTRAL AVE, SUITE 1A, CHICAGO, IL 60630-2338
(773) 736-3338
(773) 736-1289
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1632041
BLUE CROSS BLUE SHIELD
—
01
—
DF5705
RAILROAD MEDICARE
—
Enumeration date
05/03/2007
Last updated
04/18/2017
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