Anderson, Bette L

Anderson, Bette L is an sole proprietor health care provider with primary practice located at 3015 Village Office Pl , Champaign IL 61822-7674. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Anderson, Bette L can be contacted via phone (217) 355-7947.

Contact Information

Primary practice address
3015 Village Office Pl Champaign IL 61822-7674
Phone: (217) 355-7947
Fax: (217) 355-8047
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X BA0383757 Illinois
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036073436 Illinois

Profile Details

NPI number 1386612927
LBN Legal business name Anderson, Bette L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2006
Last updated Mar 28th, 2018 - about 6 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 1386612927 NPPES
Illinois Other 205022193 TRI-CARE
Illinois Other 1032096 TRI-CARE
Illinois MEDICAID 036073436 TRI-CARE
Illinois Other 960582 TRI-CARE
Illinois Other 301724 TRI-CARE

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