Vandevelde, Brad W

Vandevelde, Brad W is an individual health care provider with primary practice located at 972 Brook Forest Ave , Shorewood IL 60404-8807. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Vandevelde, Brad W can be contacted via phone (815) 439-4938.

Contact Information

Primary practice address
972 Brook Forest Ave Shorewood IL 60404-8807
Phone: (815) 439-4938
Fax: (815) 439-7816
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070-016543 Illinois

Profile Details

NPI number 1942466438
LBN Legal business name Vandevelde, Brad W
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2008
Last updated Oct 23rd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942466438 NPPES
Illinois Other P01019766 MEDICARE RAILROAD

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