Individual
DR. ANDREW MICHAEL CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
499 PHILLIPS AVE, GLEN ELLYN, IL 60137-5012
(630) 777-0462
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125082204
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2023
Last updated
06/27/2023
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