Anderson, Rick
Anderson, Rick is an individual health care provider with primary practice located at 702 W Chestnut St , Bloomington IL 61701-2814. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Anderson, Rick can be contacted via phone (309) 557-1400.Contact Information
Primary practice address
702 W Chestnut St
Bloomington IL 61701-2814
Phone: (309) 557-1400
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 036-075884 | Illinois |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 48214 | Arizona |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036.075884 | Illinois |
Profile Details
NPI number | 1396772976 |
---|---|
LBN Legal business name | Anderson, Rick |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 27th, 2006 |
Last updated | Jun 27th, 2023 - about last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1396772976 | NPPES |
Arizona | MEDICAID | 947345 |
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