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Individual

MRS. AMANDA DEVINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MAT, ATC, LAT, OTC

Contact information

Practice address
920 MILWAUKEE AVE, LINCOLNSHIRE, IL 60069-3839
(847) 838-2200
Mailing address
920 MILWAUKEE AVE, LINCOLNSHIRE, IL 60069-3839

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002963
IL

Other

Enumeration date
11/01/2011
Last updated
07/31/2017
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