Individual
DR. BRIAN DALE VANDERBILT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
40 LANDOVER PKWY, HAWTHORN WOODS, IL 60047-7508
(847) 719-2225
(847) 719-2527
Mailing address
84 SUMMERHILL DR, MUNDELEIN, IL 60060-4556
(847) 719-2225
(847) 719-2527
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04932406
BCBSIL PIN #
IL
Enumeration date
09/07/2005
Last updated
07/08/2007
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