Individual
KELLY DANIELAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
8429 LATROBE AVE, SKOKIE, IL 60077-2155
(847) 946-7732
Mailing address
8429 LATROBE AVE, SKOKIE, IL 60077-2155
(847) 946-7732
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.005308
IL
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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