Individual
MISS COURTNEY KAE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2520 ELISHA AVE, ZION, IL 60099-2676
(847) 872-4888
Mailing address
2520 ELISHA AVE, ZION, IL 60099-2676
(847) 872-4888
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004443
IL
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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