Abderholden, Guy R

Abderholden, Guy R is an individual health care provider with primary practice located at 543 Orchard St , Antioch IL 60002-3107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Abderholden, Guy R can be contacted via phone (847) 395-3322.

Contact Information

Primary practice address
543 Orchard St Antioch IL 60002-3107
Phone: (847) 395-3322
Fax: (847) 395-0921
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 33453020 Wisconsin
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-084853 Illinois

Profile Details

NPI number 1902899792
LBN Legal business name Abderholden, Guy R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2005
Last updated Dec 10th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902899792 NPPES
Illinois MEDICAID 0360848531

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