Individual
JOSUE DAVID VILLACIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5530 S ELLIS AVE, CHICAGO, IL 60637-1402
(773) 858-0330
Mailing address
5412 N KENMORE AVE APT 1W, CHICAGO, IL 60640-1810
(773) 858-0330
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004155
IL
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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