Individual
MR. JASON SCOTT PEQUETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,ATC,CSCS
Contact information
Practice address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 269-2222
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096-001043
IL
Other
Enumeration date
03/14/2006
Last updated
01/19/2015
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