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NPI Code Detail

MEDICARE: JOSHUA ANDERSEN

MEDICARE:   JOSHUA  ANDERSEN
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
1183500000XPharmacist051289323IL

General Provider Information

NPI Number : 1073150066
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA ANDERSEN
Provider Business Mailing Address
First Line : 1780 WALL ST
Second Line :
City : MT PROSPECT
State : IL
Zip : 60056-5790
Country : US
Telephone Number : 847-264-7100
Fax Number :
Provider Business Practice Location Address
First Line : 1780 WALL ST
Second Line :
City : MT PROSPECT
State : IL
Zip : 60056-5790
Country : US
Telephone Number : 847-264-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2019
Last Update Date : 12/09/2019

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Directions to “ JOSHUA ANDERSEN ” Practice Location

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