Provider Demographics
NPI:1013908375
Name:ALLDREDGE, ANDREW L (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:L
Last Name:ALLDREDGE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1918 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-8020
Mailing Address - Country:US
Mailing Address - Phone:847-913-8978
Mailing Address - Fax:847-383-4325
Practice Address - Street 1:1701 N BUFFALO GROVE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-6888
Practice Address - Country:US
Practice Address - Phone:847-955-9361
Practice Address - Fax:847-955-9365
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist