Individual
MICHELLE VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1222 S JEFFERSON ST, LOCKPORT, IL 60441-3541
(815) 588-8644
Mailing address
19741 S GLASGOW DR, FRANKFORT, IL 60423-8807
(815) 409-2752
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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