Individual
REBECCA J ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050
(815) 759-3100
Mailing address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 759-3100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036118364
IL
207P00000X
Emergency Medicine Physician
242008
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036118364
STATE LICENSE
IL
Enumeration date
11/16/2006
Last updated
05/14/2018
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