Individual
IAN VANANTWERP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
701 N FIRST ST RM D442, SPRINGFIELD, IL 62769-1000
(217) 545-0193
(217) 545-8156
Mailing address
PO BOX 19636, SPRINGFIELD, IL 62794-9636
(217) 545-8000
(217) 545-8534
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
82153-21
WI
2085R0202X
Diagnostic Radiology Physician
Primary
125078762
IL
Other
Enumeration date
04/01/2021
Last updated
04/15/2026
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