Healthcare Provider Details

I. General information

NPI: 1669598843
Provider Name (Legal Business Name): DAVID V. TRANDEL PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 OREGON AVE
WEST DUNDEE IL
60118-2030
US

IV. Provider business mailing address

214 OREGON AVE
WEST DUNDEE IL
60118-2030
US

V. Phone/Fax

Practice location:
  • Phone: 847-551-9698
  • Fax:
Mailing address:
  • Phone: 847-551-9698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: