Individual
ANDREA IRENE RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
40 S CLAY ST, HINSDALE, IL 60521-3257
(630) 286-5050
(630) 286-5052
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
96001592
IL
363AM0700X
Medical Physician Assistant
Primary
085003364
IL
Other
Enumeration date
03/09/2006
Last updated
06/17/2022
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