Individual
CIRE NICOLAS JUANICO TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
870 GREENWOOD DR, LINDENHURST, IL 60046-1717
(224) 518-3215
Mailing address
870 GREENWOOD DR, LINDENHURST, IL 60046-1717
(224) 518-3215
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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