Individual
PATRICIA JEWELL ANDRISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
333 CHESTNUT ST, SUITE 206, HINSDALE, IL 60521-3247
(630) 850-9650
(630) 850-9607
Mailing address
333 CHESTNUT, SUITE 206, HINSDALE, IL 60521
(630) 850-9650
(630) 850-9607
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2205358
BCBS
IL
Enumeration date
11/25/2005
Last updated
11/23/2007
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