Individual
MRS. ANDREA MARIE DEWASME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1526 CREEK DR, MORRIS, IL 60450-6862
(815) 416-1132
(815) 416-1135
Mailing address
815 E NORTH ST, MORRIS, IL 60450-2345
(815) 416-1132
(815) 416-1135
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-009326
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3232011
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/13/2006
Last updated
01/22/2013
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