Provider Demographics
NPI:1437184702
Name:VANBEEK, LYNETTE D (PT)
Entity Type:Individual
Prefix:MS
First Name:LYNETTE
Middle Name:D
Last Name:VANBEEK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-2130
Mailing Address - Country:US
Mailing Address - Phone:847-362-9867
Mailing Address - Fax:847-573-4201
Practice Address - Street 1:801 MILWAUKEE AVE
Practice Address - Street 2:CONDELL MEDICAL CENTER
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3204
Practice Address - Country:US
Practice Address - Phone:847-990-5805
Practice Address - Fax:847-573-4201
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist