Provider Demographics
NPI:1700091535
Name:ANDERSON, HELEN (APN)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W ALGONQUIN RD
Mailing Address - Street 2:BUILDING A ROOM 364
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-7373
Mailing Address - Country:US
Mailing Address - Phone:847-925-6268
Mailing Address - Fax:847-925-6206
Practice Address - Street 1:1200 W ALGONQUIN RD
Practice Address - Street 2:BUILDING A ROOM 364
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-7373
Practice Address - Country:US
Practice Address - Phone:847-925-6268
Practice Address - Fax:847-925-6206
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-005195363LW0102X
TXAP107782363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS67128Medicare ID - Type UnspecifiedPART B