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Individual

MR. ANTOIN DESHAUN SHINAUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
205 W WACKER DR STE 1020, CHICAGO, IL 60606-1452
(312) 640-0329
(312) 640-0407
Mailing address
5381 BURR OAK RD, LISLE, IL 60532-2107
(773) 543-1752

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003501
IL

Other

Enumeration date
11/13/2014
Last updated
11/13/2014
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