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Individual

MATTHEW ROBERT WHITESELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSA, ATC

Contact information

Practice address
401 S STATE ST, ROBERT MORRIS UNIVERSITY, CHICAGO, IL 60605-1229
(847) 718-6707
(312) 935-4079
Mailing address
401 S. STATE ST., ROBERT MORRIS UNIVERSITY, CHICAGO, IL 60605
(847) 718-6707
(312) 935-4079

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0000001156
TN
2255A2300X
Athletic Trainer
Primary
096002069
IL

Other

Enumeration date
12/12/2007
Last updated
12/10/2015
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