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NPI Code Detail

MEDICARE: TARA ANDERSON MD

MEDICARE: TARA ANDERSON 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
1207V00000XObstetrics & Gynecology Physician036-095844IL

General Provider Information

NPI Number : 1891781035
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA ANDERSON MD
Provider Business Mailing Address
First Line : 2040 OGDEN AVE STE 201
Second Line :
City : AURORA
State : IL
Zip : 60504-7205
Country : US
Telephone Number : 630-978-6886
Fax Number : 630-978-6806
Provider Business Practice Location Address
First Line : 2040 OGDEN AVE
Second Line : SUITE 201
City : AURORA
State : IL
Zip : 60504-7222
Country : US
Telephone Number : 630-978-6886
Fax Number : 630-978-6806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2005
Last Update Date : 04/06/2020

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Directions to “ TARA ANDERSON MD” Practice Location

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