Individual
MELISSA L MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4555 211TH ST, MATTESON, IL 60443-2318
(708) 283-0021
(708) 283-0831
Mailing address
2017 WEBSTER LN, DES PLAINES, IL 60018-2722
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096-002694
IL
Other
Enumeration date
01/28/2009
Last updated
01/28/2009
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