Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Jerrick Anderson

Individual provider Internal Medicine Physician · NPI 1982454716

Ethan Jerrick Anderson is an Internal Medicine Physician in Park Ridge, Illinois. Licensed in Illinois. Registered with an NPI since 2024.

Licensed in
IL
In the registry since
2024
Specialties on file
2

Practice location Address checks out

1775 Ballard Rd
Park Ridge, IL 60068-1005
Phone: (847) 318-9340
Fax: (847) 318-2966
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 1982454716 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1982454716
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 25, 2024
Last updated in NPPESJune 13, 2024
Certification dateJune 13, 2024
Mailing address1360 E 58th St Apt G, Chicago, IL 60637-5213

Other providers in Park Ridge