Provider Demographics
NPI:1457021297
Name:VANPAMEL, TIMOTHY FRANCIS
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:FRANCIS
Last Name:VANPAMEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7228 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53143-5554
Mailing Address - Country:US
Mailing Address - Phone:262-960-4918
Mailing Address - Fax:
Practice Address - Street 1:7228 7TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53143-5554
Practice Address - Country:US
Practice Address - Phone:262-960-4918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056003567225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist