Individual
MR. JERRY MARK BORNHOFF
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, CSCS
Contact information
Practice address
1111 S DEE RD, PARK RIDGE, IL 60068-4379
(847) 692-8246
Mailing address
147 S CRANBERRY ST, BOLINGBROOK, IL 60490-2094
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
10/19/2005
Last updated
07/08/2007
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