Individual
PETER MAINVILLE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1060 W ADDISON ST, CHICAGO, IL 60613-4566
(773) 404-4222
Mailing address
1408 W PLYMOUTH DR, ARLINGTON HEIGHTS, IL 60004-2845
(224) 735-2183
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003512
IL
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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