DR. Russell E Anderson

NPI #1124328794 in Fox Lake, Illinois

Provider Information

NPI Number: 1124328794
Entity Type: Individual
Name: DR. Russell E Anderson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Oct 28, 2010
Last Updated: May 22, 2016

Practice Location

Address: 1258 S ROUTE 12
City: Fox Lake
State: Illinois
ZIP Code: 60020-1950
Phone: (847) 587-4966

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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