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Individual

JOHN C ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
135 N GREENLEAF ST, SUITE 202, GURNEE, IL 60031-3393
(847) 336-3200
(847) 336-1720
Mailing address
135 N GREENLEAF ST, SUITE 202, GURNEE, IL 60031-3393
(847) 336-3200

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
21-5871
IL

Other

Enumeration date
11/13/2008
Last updated
11/13/2008
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