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NPI Code Detail

MEDICARE: ANDREW ELDER

MEDICARE: ANDREW ELDER
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
1363A00000XPhysician AssistantIL

General Provider Information

NPI Number : 1780547307
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW ELDER
Provider Business Mailing Address
First Line : 836 SHAGBARK LN APT 301
Second Line :
City : NORTH AURORA
State : IL
Zip : 60542-1434
Country : US
Telephone Number : 630-687-5981
Fax Number :
Provider Business Practice Location Address
First Line : 1310 N MAIN ST STE 200
Second Line :
City : SANDWICH
State : IL
Zip : 60548-1397
Country : US
Telephone Number : 630-687-5981
Fax Number : 815-981-7530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “ ANDREW ELDER ” Practice Location

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