Individual
CRYSTAL MARIE VANDERVEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
19000 HALSTED ST, HOMEWOOD, IL 60430-4204
(708) 957-9200
Mailing address
19000 HALSTED ST, HOMEWOOD, IL 60430-4204
(708) 957-9200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146007440
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932114
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/08/2007
Last updated
02/18/2022
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