Individual
NICOLE VANDERVLIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3 ERIE CT, OAK PARK, IL 60302-2519
(708) 383-6200
Mailing address
3064 BONITA DR SE, GRAND RAPIDS, MI 49508-1424
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
056.008534
IL
Other
Enumeration date
12/29/2008
Last updated
12/29/2008
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