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Individual

RONALD DEWALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1645 W BROADLAND LN, LAKE FOREST, IL 60045-4813
(847) 234-5841
(847) 234-5919
Mailing address
1645 W BROADLAND LN, LAKE FOREST, IL 60045-4813
(847) 234-5841
(847) 234-5919

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036.036945
IL
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
036.036945
IL

Other

Enumeration date
09/27/2016
Last updated
09/27/2016
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