| Doctor Name: | DR. ANDREA S. DIRKSEN |
| NPI Number: | 1194909309 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPM |
| License Number: | 016.005320 |
| Business Practice Address: | 1400 Us Highway 51 N Unit 7 Arbor Vitae, WI - 545689504 |
| Business Phone Number: | 7795374134 |
| Business Fax Number: | |
| Mailing Address: | 5492 Heartwood Ln, ROSCOE |
| State: | IL |
| Postal Code: | 610737922 |
| Phone Number: | 7795374134 |
| Fax Number: | |
| NPI Enumeration Date: | 12/24/2007 |
| NPI Last Update Date: | 02/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 016.005320 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |