Active NPI
Christopher N McAndrew, MA, ATC, CES
- Athletic Trainer
- Mount Vernon, IL
National Provider Identifier
1790061950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.002793
- Practice address
- 1129 Douglas St
Mount Vernon, IL 62864-5706 - Phone
- (630) 270-5181
- NPI assigned
- Nov 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.002793 | IL | Primary |
Addresses
Primary practice location
1129 Douglas St
Mount Vernon, IL 62864-5706
Mailing address
1129 Douglas St
Mount Vernon, IL 62864-5706
Phone (630) 270-5181
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.002793 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320105600000",
"number": "1790061950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1129 DOUGLAS ST",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628645706",
"telephone_number": "630-270-5181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1129 DOUGLAS ST",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628645706",
"telephone_number": "630-270-5181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCANDREW",
"first_name": "CHRISTOPHER",
"middle_name": "N",
"credential": "MA, ATC, CES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-01",
"last_updated": "2011-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.002793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.