Individual
ANDREW T HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61603-4307
(309) 672-5522
Mailing address
21276 NETWORK PLACE, CHICAGO, IL 60673-0001
(877) 485-4474
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036099169
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36099169
BCBS
IL
Enumeration date
02/06/2006
Last updated
12/09/2020
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