Individual
MRS. JACQUELINE J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
3082 CATON FARM RD, JOLIET, IL 60435-1455
(815) 577-9936
Mailing address
5117 EASTCHESTER CT, PLAINFIELD, IL 60586-5868
(815) 267-3513
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
96001776
IL
Other
Enumeration date
02/17/2006
Last updated
02/21/2008
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