Provider Demographics
NPI:1801382924
Name:VOELSCH, ANDREW DAVID (DC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:DAVID
Last Name:VOELSCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 BONNIE BRAE PL APT 4C
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1268
Mailing Address - Country:US
Mailing Address - Phone:630-715-1010
Mailing Address - Fax:
Practice Address - Street 1:1147 S WABASH AVE STE 250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2355
Practice Address - Country:US
Practice Address - Phone:312-987-4878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor