Anderson, Darrel R

Anderson, Darrel R is an individual health care provider with primary practice located at 701 N 1St St , Springfield IL 62781-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Anderson, Darrel R can be contacted via phone (217) 788-3245.

Contact Information

Primary practice address
701 N 1St St Springfield IL 62781-0001
Phone: (217) 788-3245
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036050216 Illinois

Profile Details

NPI number 1760423032
LBN Legal business name Anderson, Darrel R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Aug 5th, 2010 - about 14 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 1760423032 NPPES
Illinois MEDICAID 036050216

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