Individual
CANDICE SUE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1333 BURR RIDGE PKWY STE 200, BURR RIDGE, IL 60527
(630) 756-5270
Mailing address
1333 BURR RIDGE PKWY STE 200, BURR RIDGE, IL 60527-0833
(630) 756-5270
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01040540A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000387969
BLUE CROSS / BLUE SHIELD
IN
01
—
000000556516
BLUE CROSS / BLUE SHIELD
IN
01
—
01064540A
MEDICAL LICENSE
IN
01
—
100200110
MEDICAID
IN
01
—
P00307969
RAILROAD MEDICARE
IN
Enumeration date
01/24/2006
Last updated
02/25/2019
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