Provider Demographics
NPI:1386839389
Name:VANDELOO, CATRINA M (FNP)
Entity type:Individual
Prefix:MS
First Name:CATRINA
Middle Name:M
Last Name:VANDELOO
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:800-647-2098
Mailing Address - Fax:314-362-3192
Practice Address - Street 1:1 MEMORIAL DR
Practice Address - Street 2:DIV MEDICAL ONCOLOGY
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6722
Practice Address - Country:US
Practice Address - Phone:800-647-2098
Practice Address - Fax:314-362-3192
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209006652363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420003629Medicaid
IL1386839389OtherRR MEDICARE