Individual
LUKE BLAESER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2856 W. 97TH PL., EVERGREEN PARK, IL 60805
(708) 499-1568
Mailing address
2856 W 97TH PL, EVERGREEN PARK, IL 60805-2650
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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