Individual
AMANDA VANDERVELDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5425
Mailing address
17725 66TH AVE, TINLEY PARK, IL 60477-4128
(708) 674-1659
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/23/2012
Last updated
07/23/2012
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