Individual
THERESA DOUANGSITHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
721 OAK ST, ELGIN, IL 60123-7411
(224) 735-6804
Mailing address
721 OAK ST, ELGIN, IL 60123-7411
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/28/2019
Last updated
12/02/2019
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