Individual
JACLEEN A LAMPERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3900 E RAAB RD, NORMAL, IL 61761-9487
(309) 261-4254
Mailing address
12860 E 2500 NORTH RD, HUDSON, IL 61748-7607
(309) 261-4254
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096.001206
CERTIFIED ATHLETIC TRAINER
IL
Enumeration date
02/09/2021
Last updated
02/09/2021
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