Individual
MR. GREGG JON MACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
929 W HIGGINS RD, SCHAUMBURG, IL 60195-3203
(847) 285-4385
(847) 285-4240
Mailing address
929 W HIGGINS RD, SCHAUMBURG, IL 60195-3203
(847) 285-4385
(847) 285-4240
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096-000773
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096.000773
STATE LICENSE NUMBER
IL
01
—
099502478
BOARD OF CERTIFICATION NUMBER
IL
Enumeration date
11/30/2005
Last updated
05/19/2011
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