Individual
LAUREN RENE LIAKOPOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5200 132ND CT, CRESTWOOD, IL 60445-4443
(708) 819-5225
Mailing address
5200 132ND CT, CRESTWOOD, IL 60445-4443
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003215
IL
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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