Mellgren, Anders
Mellgren, Anders is an individual health care provider with primary practice located at 1801 W Taylor St 3F Occ, Chicago IL 60612-4795. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Mellgren, Anders can be contacted via phone (312) 355-4300.Contact Information
Primary practice address
1801 W Taylor St 3F Occ
Chicago IL 60612-4795
Phone: (312) 355-4300
Fax: (312) 413-1206
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 45364 | Minnesota |
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 036.133002 | Illinois |
Profile Details
NPI number | 1053320671 |
---|---|
LBN Legal business name | Mellgren, Anders |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 5th, 2006 |
Last updated | Jul 8th, 2016 - about 9 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1053320671 | NPPES |
Illinois | MEDICAID | 036.133002 | |
Illinois | MEDICAID | 764487600 |
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