Provider Demographics
NPI:1316057599
Name:VANDERSCHAEGEN, DYLYNN M (RPH)
Entity type:Individual
Prefix:MS
First Name:DYLYNN
Middle Name:M
Last Name:VANDERSCHAEGEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9048 W US HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:SAXON
Mailing Address - State:WI
Mailing Address - Zip Code:54559-9588
Mailing Address - Country:US
Mailing Address - Phone:715-893-2191
Mailing Address - Fax:
Practice Address - Street 1:200 E AYER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-2070
Practice Address - Country:US
Practice Address - Phone:906-932-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302029603183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist