Anderson, Edgar

Anderson, Edgar is an individual health care provider with primary practice located at 1160 S 1St Ave Loyola University Medical Center 101-1740, Maywood IL 60153-2312. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Anderson, Edgar can be contacted via phone (708) 216-9000.

Contact Information

Primary practice address
1160 S 1St Ave Loyola University Medical Center 101-1740 Maywood IL 60153-2312
Phone: (708) 216-9000
Fax: (708) 216-9033
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 36102114 Illinois

Profile Details

NPI number 1679550735
LBN Legal business name Anderson, Edgar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Jul 8th, 2007 - about 17 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 1679550735 NPPES
Illinois MEDICAID 36102114

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