Individual
MR. ROBERT WASSILAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1611 W HARRISON ST, CHICAGO, IL 60612-4861
(312) 432-2489
Mailing address
1611 W HARRISON ST, CHICAGO, IL 60612-4861
(312) 432-2489
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096-000452
IL
Other
Enumeration date
07/25/2006
Last updated
04/18/2016
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