Individual
ALLAN CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
102 MERCURY DR, CHAMPAIGN, IL 61822-9650
(217) 363-5205
Mailing address
1337 JEFFREY DR, RANTOUL, IL 61866-1705
(815) 302-9577
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096002191
IL
2255A2300X
Athletic Trainer
AL2023
FL
2255A2300X
Athletic Trainer
AT001604
GA
2255A2300X
Athletic Trainer
AT3267
TX
2255A2300X
Athletic Trainer
ATH.200358
LA
2255A2300X
Athletic Trainer
—
SC
Other
Enumeration date
03/16/2007
Last updated
12/19/2018
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