Individual
DIANNE M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1327 BUTTERFIELD RD, 618, DOWNERS GROVE, IL 60515-1078
(630) 322-8300
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
46008380
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008380
—
IL
Enumeration date
11/14/2006
Last updated
03/21/2011
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