Individual
MR. ROBERT E LACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
9634 S PULASKI RD, OAK LAWN, IL 60453-3391
(708) 423-4800
Mailing address
10933 S CENTRAL PARK AVE, CHICAGO, IL 60655-3304
(773) 779-5414
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/04/2008
Last updated
03/04/2008
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