Individual
AMANDA GRACE VANDER WAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1441 BRANDING AVE STE 310, DOWNERS GROVE, IL 60515-5624
(630) 829-1084
(630) 829-1040
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2073
MN
363LF0000X
Family Nurse Practitioner
Primary
209.009874
IL
Other
Enumeration date
10/09/2012
Last updated
10/08/2024
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