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NPI Code Detail

MEDICARE: MR. WILLIAM A ANDEL ANP

MEDICARE: MR. WILLIAM A ANDEL ANP
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
1363LA2200XAdult Health Nurse Practitioner139341MO
2363L00000XNurse Practitioner209004018IL

Other Identifiers

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

General Provider Information

NPI Number : 1821048372
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM A ANDEL ANP
Provider Business Mailing Address
First Line : 1005 BROADWAY ST
Second Line :
City : QUINCY
State : IL
Zip : 62301-2834
Country : US
Telephone Number : 217-223-8400
Fax Number : 217-277-3960
Provider Business Practice Location Address
First Line : 4800 MAINE ST
Second Line :
City : QUINCY
State : IL
Zip : 62305-5875
Country : US
Telephone Number : 217-214-0444
Fax Number : 217-214-9638
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 06/03/2024

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