Individual
MRS. KATIE S. VANDERBILT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
84 SUMMERHILL DR, MUNDELEIN, IL 60060-4556
(847) 708-1786
(847) 719-2527
Mailing address
84 SUMMERHILL DR, MUNDELEIN, IL 60060-4556
(847) 708-1786
(847) 719-2527
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4932549
BCBSIL
IL
Enumeration date
08/19/2006
Last updated
07/08/2007
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