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General NPI Number Information
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NPI Number | 1740524727
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Entity Type | Individual
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Provider Name | ANDREA ERICKSON BEST DO
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Gender | Female
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 510 BUENA RD
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City | LAKE FOREST
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State | IL
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Zip | 60045-4409
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Country | US
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Telephone | 847-846-3414
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Fax |
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Provider Business Mailing Address
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Address Line | 510 BUENA RD
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City | LAKE FOREST
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State | IL
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Zip | 60045-4409
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Country | US
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Telephone | 847-846-3414
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 036096838
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License Number State | IL
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