Individual
ERIN O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1200 S MCHENRY AVE, CRYSTAL LAKE, IL 60014-7495
(815) 455-3860
Mailing address
1405 W SAPPHIRE DR, HOFFMAN ESTATES, IL 60192-3814
(815) 814-3616
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096004198
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
10/09/2018
Last updated
10/09/2018
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