Individual
MRS. JACLYN MAE SKROBOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
110 MOONEY DR, BOURBONNAIS, IL 60914-2171
(815) 936-0611
Mailing address
19 PARK PL, KANKAKEE, IL 60901-6005
(815) 937-1731
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096-001580
IL
Other
Enumeration date
02/15/2006
Last updated
10/18/2010
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