Individual
DR. KENNETH PAUL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 570-2008
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 570-2008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.121924
IL
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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