John C Anderson Valid NPI
Individual provider · Periodontics · Gurnee, IL
- NPI
- 1558515726
- Type
- Individual (Type 1)
- Primary specialty
- Periodontics (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223P0300X
- License number
- 21-5871 (IL)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2008-11-13
- Last updated
- 2008-11-13
Practice location
135 N Greenleaf St, Suite 202
Gurnee, IL 60031-3393
(847) 336-3200