Provider Demographics
NPI:1316791213
Name:ANDRESHAK, ANTHONY GUIDO (DO)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:GUIDO
Last Name:ANDRESHAK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19637 BRILLHART RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-8825
Mailing Address - Country:US
Mailing Address - Phone:419-356-7158
Mailing Address - Fax:
Practice Address - Street 1:20201 S. CRAWFORD,
Practice Address - Street 2:ATTN: POSTDOCTORAL EDUCATION
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461
Practice Address - Country:US
Practice Address - Phone:708-747-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program