Individual
MS. LAURA KATHLEEN ADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1501 CENTRAL ST, EVANSTON, IL 60208-0840
(847) 467-2406
Mailing address
1246 W PRATT BLVD, APT 1402, CHICAGO, IL 60626-4363
(971) 244-3898
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004074
IL
Other
Enumeration date
01/02/2016
Last updated
01/02/2016
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