Dr. Kenneth Paul Anderson, D.O.
Family Medicine in Evanston, IL. Individual provider (NPI-1).
NPI number1811146483
StatusActive
Last updated in NPPESSep 18, 2008
Details
- NPI
- 1811146483
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kenneth Paul Anderson
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 18, 2008
- Last updated
- Sep 18, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 036.121924 | IL | Yes |
Other names
- Kenneth Paul Anderson (Former Name)
Practice location
2650 Ridge AveEvanston, IL 60201-1718
Phone 847-570-2008
Mailing address
2650 Ridge AveEvanston, IL 60201-1718
Phone 847-570-2008
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