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Contact Information

DERRIUS J ANDERSON, MD
5841 S MARYLAND AVE # MC1052
CHICAGO, IL60637-1443
 Phone: 773-702-2500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for DERRIUS J ANDERSON · (Male)

NPI # 1003436163
Status Active
Credentials MD
Entity Individual
Enumeration date 04/19/2020
Last updated 05/29/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 125.076207
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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