Provider Demographics
NPI:1992775340
Name:ANDREWS, JOHN R (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:800 N WESTMORELAND RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1673
Mailing Address - Country:US
Mailing Address - Phone:847-234-4310
Mailing Address - Fax:847-234-4336
Practice Address - Street 1:800 N WESTMORELAND RD
Practice Address - Street 2:SUITE 205
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1673
Practice Address - Country:US
Practice Address - Phone:847-234-4310
Practice Address - Fax:847-234-4336
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF21844Medicare UPIN
IL971030Medicare ID - Type Unspecified