Organization
ANDERSONTIERNAN, INC
Active
Parent organization
ANDERSONTIERNAN, INC
Other names
Advanced Foot & Ankle Centers of Illinois
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANDERSONTIERNAN, INC
Authorized official
DR. DANA M. WISBY DPM (MEDICAL DIRECTOR)
(847) 985-8380
Entity
Organization
Contact information
Practice address
455 S ROSELLE RD, SUITE 100, SCHAUMBURG, IL 60193-2971
(847) 985-8380
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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