Individual
SHANTI CALABRESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 HESSEL BLVD, CHAMPAIGN, IL 61820-6416
(312) 282-8760
Mailing address
302 HESSEL BLVD, CHAMPAIGN, IL 61820-6416
(312) 282-8760
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003482
IL
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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