Individual
MR. MATTHEW SCOTT REPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2401 RAVINE WAY, SUITE 100, GLENVIEW, IL 60025-7645
(847) 724-4791
Mailing address
9326 KEDVALE AVE, SKOKIE, IL 60076-1421
(847) 269-9326
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002602
IL
Other
Enumeration date
09/05/2008
Last updated
09/05/2008
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