Individual
ADAM ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
100 E WALTON STREET, SUITE 700, CHICAGO, IL 60611-1448
(312) 642-3963
(312) 642-3966
Mailing address
PO BOX 207, WORTH, IL 60482-0207
(708) 403-1155
(708) 403-1177
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
07013087
IL
174400000X
Specialist
—
IL
Other
Enumeration date
11/12/2007
Last updated
03/17/2008
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