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Organization
ANDREW WILLSON
Active
Organization
ANDREW WILLSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW WILLSON ATC (ATHLETIC TRAINER)
(269) 598-1758
Entity
Organization
Contact information
Practice address
915 W CARMEN AVE, APT 506, CHICAGO, IL 60640-3261
(269) 598-1758
Mailing address
915 W CARMEN AVE, APT 506, CHICAGO, IL 60640-3261
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003776
IL
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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