Individual
PHILIP TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 MOONEY DR, SUITE 5, BOURBONNAIS, IL 60914-2171
(815) 936-0611
Mailing address
110 MOONEY DR, SUITE 5, BOURBONNAIS, IL 60914-2171
(815) 936-0611
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096002399
IL
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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