Provider Demographics
NPI:1750359592
Name:ACCARDI, ANDREW E (ATC/L)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:E
Last Name:ACCARDI
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 S DEMENT AVE
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021-3110
Mailing Address - Country:US
Mailing Address - Phone:815-288-7846
Mailing Address - Fax:815-625-8444
Practice Address - Street 1:313 S DEMENT AVE
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-3110
Practice Address - Country:US
Practice Address - Phone:815-288-7846
Practice Address - Fax:815-625-8444
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer