Individual
LISA PORTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2240 FOREST AVE, ROLLING MEADOWS, IL 60008-1328
(847) 370-3747
Mailing address
2240 FOREST AVE, ROLLING MEADOWS, IL 60008-1328
(847) 370-3747
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096002981
IL
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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