Provider Demographics
NPI:1902981459
Name:ANDERSON, CLAIRE L (APN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:L
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2088 OGDEN AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4383
Mailing Address - Country:US
Mailing Address - Phone:630-851-6440
Mailing Address - Fax:630-518-7001
Practice Address - Street 1:2088 ODGEN AVENUE
Practice Address - Street 2:SUITE 160
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504
Practice Address - Country:US
Practice Address - Phone:630-851-6440
Practice Address - Fax:630-851-7001
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277000400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL277000400Medicaid