Individual
MR. GREGORY BRIAN NORDLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., ATC/L, PES
Contact information
Practice address
5530 S ELLIS AVE, CHICAGO, IL 60637-1402
(773) 702-1048
Mailing address
1668 WILLIAMSBURG CT., UNIT D, WHEATON, IL 60189
(630) 215-8885
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003122
IL
Other
Enumeration date
08/28/2012
Last updated
12/09/2014
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