Individual
MR. ANTONIO ANDERE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4618 W 115TH PL, ALSIP, IL 60803-2214
(708) 529-8814
Mailing address
4618 W 115TH PL, ALSIP, IL 60803-2214
(708) 529-8814
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005548
IL
Other
Enumeration date
11/21/2011
Last updated
11/21/2011
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