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General NPI Number Information
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NPI Number | 1225529381
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Entity Type | Individual
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Provider Name | ANDREA ELIZABETH GEDDES MD, MS
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Gender | Female
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 800 AUSTIN ST STE 563
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City | EVANSTON
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State | IL
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Zip | 60202-3456
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Country | US
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Telephone | 847-869-0522
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Fax |
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Provider Business Mailing Address
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Address Line | 800 AUSTIN ST STE 563
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City | EVANSTON
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State | IL
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Zip | 60202-3456
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Country | US
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Telephone | 847-869-0522
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036164389
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License Number State | IL
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