Provider Demographics
NPI:1619356920
Name:VANBECK, CHERYL LYNNE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LYNNE
Last Name:VANBECK
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 E LAKE COOK RD
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1999
Mailing Address - Country:US
Mailing Address - Phone:800-317-0711
Mailing Address - Fax:
Practice Address - Street 1:2000 TOWN CTR
Practice Address - Street 2:SUITE 1900
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-1135
Practice Address - Country:US
Practice Address - Phone:800-317-0711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902015134124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist