Individual
TAMARA SAGADORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
180 N ADELAIDE ST, NORMAL, IL 61761-2404
(309) 438-3340
Mailing address
19 TRADERS CIR, APT 368A, NORMAL, IL 61761-4149
(309) 532-0103
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003724
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2-4778
CERTIFIED ATHLETIC THERAPIST CAT(C)
—
Enumeration date
09/02/2015
Last updated
09/02/2015
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