Provider Demographics
NPI:1417341785
Name:BIRKHEAD, ANDREW GARTNER (MD FAAFP FASAM)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GARTNER
Last Name:BIRKHEAD
Suffix:
Gender:
Credentials:MD FAAFP FASAM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1135 W 69TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60621-1147
Mailing Address - Country:US
Mailing Address - Phone:773-483-5011
Mailing Address - Fax:773-483-5259
Practice Address - Street 1:1135 W 69TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-1147
Practice Address - Country:US
Practice Address - Phone:773-483-5011
Practice Address - Fax:773-483-5259
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.144124207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine