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Individual

THEODORE A VORENKAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
425 HUEHL RD, UNIT 13, NORTHBROOK, IL 60062-2319
(800) 654-3772
Mailing address
56282 KINGSMEN CT, MISHAWAKA, IN 46545-7617
(574) 255-1178

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000535A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000089860
BC/ BS, ANTHEM
IN
01
0005706081
AETNA
IN
05
100409860A
IN
05
100409860D
IN
01
480014969
RAILROAD MEDICARE
IN
Enumeration date
04/19/2006
Last updated
05/26/2013
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