MEDICARE: JOSHUA ANDRE

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1376406413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA ANDRE

Provider Business Mailing Address
First Line	:	243 FAIRVIEW AVE
Second Line	:
City	:	DEERFIELD
State	:	IL
Zip	:	60015-4730
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	243 FAIRVIEW AVE
Second Line	:
City	:	DEERFIELD
State	:	IL
Zip	:	60015-4730
Country	:	US
Telephone Number	:	224-275-2063
Fax Number	:

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

Provider Enumeration Date	:	12/05/2025
Last Update Date	:	12/05/2025

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Directions to “ JOSHUA ANDRE ” Practice Location

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