MEDICARE: JOHN S ANDREWS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	036.147862	IL
2	208000000X	Pediatrics Physician	46329	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003808114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN S ANDREWS MD

Provider Business Mailing Address
First Line	:	330 N WABASH AVE STE 39300
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5885
Country	:	US
Telephone Number	:	312-464-5456
Fax Number	:	312-224-6912

Provider Business Practice Location Address
First Line	:	467 W DEMING PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1881
Country	:	US
Telephone Number	:	312-227-8800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	06/19/2019

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Directions to “ JOHN S ANDREWS MD” Practice Location

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