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Contact Information

JON E ANDERSEN, DO
390 MAPLE SUMMIT RD
JERSEYVILLE, IL62052-2000
 Phone: 618-498-2101
 Fax: 618-498-2787
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JON E ANDERSEN · (Male)

NPI Number 1841304888
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/18/2006
Last updated 11/13/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 036102731
  • IL Medicaid 036102731
  • IL Other 11807598 CAQH ID
  • IL Other 067210 HEALTH ALLIANCE
  • IL Other 431532 HEALTHLINK
  • IL Other 784310 MEDICARE
Hospital affiliation(s)
  • JERSEY COMMUNITY HOSPITAL - (Acute Care)
    400 MAPLE SUMMIT ROAD
    JERSEYVILLE, IL 62052
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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