Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038006449 | IL |
N | 175L00000X | Homeopath |
NPI | 1063423234 |
---|---|
Provider Name | Dr. Pieter A Van Heule |
First Address | Wilmette, IL 60091-2717 |
Second Address | Wilmette, IL 60091-2717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 09/08/2009 |