EDGAR ANDERSON (NPI# 1679550735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679550735 |
| Entity Type | Individual |
| Full Name | EDGAR ANDERSON |
| Credential | MD |
| Practice Address |
1160 S 1st Ave Loyola University Medical Center 101-1740 Maywood IL 60153-2312 |
| Mailing Address |
2160 S 1st Ave Loyola University Medical Center 101-1740 Maywood IL 60153-3328 |
| Practice Telephone | 7082169000 |
| Practice Fax Number | 7082169033 |
| Mailing Telephone | 7082169000 |
| Mailing Fax Number | 7082169033 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 36102114 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 36102114 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437403730 | Edgar Leopold Anderson | Registered Nurse | 1690 Dunlawton Ave Ste 125, Port Orange, FL 32127-8980 | 2012-11-08 |
| Street Address |
1160 S 1ST AVE LOYOLA UNIVERSITY MEDICAL CENTER 101-1740 |
| City | MAYWOOD |
| State | IL |
| Zip Code | 60153-2312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933077 | Judie Noemie Hoilat | Internal Medicine | 2160 S 1st Avenue, Maywood, IL 60153 | 2020-05-13 |
| 1457972457 | Yuchen Zheng | Student in an Organized Health Care Education/Training Program | Department of Neurology, Loyola University Medical Cent, 2160 S. First Ave, Maywood, IL 60153 | 2020-04-30 |
| 1437779519 | Amna Amad Siddiqui | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 | 2020-04-20 |
| 1982232211 | Brian Kurtz | Student in an Organized Health Care Education/Training Program | 2160 S First Ave, Bulding 105-suite 2840a, Maywood, IL 60153 | 2020-03-31 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| 1558919472 | Linda Sue Moton | Technician | 10 South 15 Apt. 1, Maywood, IL 60153 | 2019-09-04 |
| 1760047518 | Braden Robert Dasovic | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue Building 105/room 2700, Department, Loyola Medical Center, Maywood, IL 60153 | 2019-05-07 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
| 1053871681 | Michael V Padua | Psychiatry & Neurology | 2160 S 1st Ave Bldg, Maywood, IL 60153 | 2019-03-20 |
| Find all providers in zip 60153 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992365696 | Joy Tao | Dermatology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-06-17 |
| 1033671086 | Laryn Steadman | Dermatology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-04-01 |
| 1285195131 | Erin Morgan Garfield | Dermatology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-03-25 |
| 1295228351 | Maureen Riegert | Dermatology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2018-06-12 |
| 1922529965 | Adam Vaudreuil | Dermatology | 2160 S 1st Ave, Maywood, IL 60153 | 2017-06-29 |
| 1255862058 | Ada Tolutope Agidi | Dermatology | 2160 S 1st Ave, Maywood, IL 60153 | 2017-03-23 |
| 1275997942 | Lauren Moy | Dermatology | 2160 S 1st Ave, Maywood, IL 60153 | 2016-04-08 |
| 1073856498 | Kristin Lee | Dermatology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2013-04-03 |
| 1790930477 | Wendy Kim | Dermatology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2008-11-23 |
| 1609997998 | Lissette Carmen Ortiz-ferrer | Dermatology | 2160 S 1st Ave, Building 101, Room 1752, Maywood, IL 60153-3328 | 2007-04-03 |
| Find all providers in MAYWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.