Individual
BLAYNE DENISE YARMAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15822 132ND ST, LEMONT, IL 60439
(312) 405-0096
Mailing address
15822 132ND ST, LEMONT, IL 60439-6476
(312) 405-0096
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124-139-001-K
1ST AGENCY
IL
Enumeration date
11/01/2016
Last updated
06/07/2018
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