Individual
MARK H NILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS, CES, PES
Contact information
Practice address
1221 N HIGHLAND AVE, AURORA, IL 60506-1404
(630) 264-8966
Mailing address
1377 HARTSBURG LN, NORTH AURORA, IL 60542-8953
(630) 715-1026
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096001654
IL
Other
Enumeration date
02/14/2011
Last updated
04/04/2016
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