Individual
JOSEPH E VANDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10350 HALIGUS RD, HUNTLEY, IL 60142-9545
(224) 654-0910
Mailing address
PO BOX 75081, CHICAGO, IL 60675-5081
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209024588
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/10/2021
Last updated
01/24/2022
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