Organization
ILLINOIS MATH AND SCIENCE ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE E MOORE ATC/L (ATHLETIC TRAINER CERTIFIED)
(630) 907-5992
Entity
Organization
Contact information
Practice address
1500 SULLIVAN RD, AURORA, IL 60506-1067
(630) 907-5000
Mailing address
343 BERWICK DR, AURORA, IL 60506-4403
(630) 896-1337
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Enumeration date
07/17/2006
Last updated
08/22/2020
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