Provider Demographics
NPI:1558380709
Name:VANDEHEY CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:VANDEHEY CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR. / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:VANDEHEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-933-7231
Mailing Address - Street 1:1230 ARMOUR RD
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-2106
Mailing Address - Country:US
Mailing Address - Phone:815-933-5688
Mailing Address - Fax:815-933-3512
Practice Address - Street 1:1230 ARMOUR RD
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2106
Practice Address - Country:US
Practice Address - Phone:815-933-5688
Practice Address - Fax:815-933-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4682110OtherBLUE CROSS BLUE SHIELD
IL208218Medicare ID - Type Unspecified