Provider Demographics
NPI:1710117452
Name:SANDEL, DAVID W (MS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:SANDEL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-1531
Mailing Address - Country:US
Mailing Address - Phone:217-344-2436
Mailing Address - Fax:
Practice Address - Street 1:1108 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-1531
Practice Address - Country:US
Practice Address - Phone:217-344-2436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral