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Individual

ELIZABETH ANTOSZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2234 LAKE RIDGE DRIVE, GLENDALE HEIGHTS, IL 60139
(224) 636-1992
Mailing address
3899 NOBEL DRIVE, 1421, SAN DIEGO, CA 92122

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
E3297785
CA
2255A2300X
Athletic Trainer
Primary
20000017381
IL

Other

Enumeration date
02/13/2017
Last updated
02/13/2017
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