NPI 1003436163

Derrius J. Anderson, MD

Practitioner Surgery Physician Chicago, IL

Practice location

Address: 5841 S Maryland Ave # Mc1052, Chicago, IL 60637-1443
Phone: (773) 702-2500
Mailing address: 180 Harvester Dr STE 110, Burr Ridge, IL 60527-6686

Registered specialties (2)

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 125.076207 (IL)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003436163
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Apr 2020
Record last updated: 29 May 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.