Individual
EMMA NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6200
Mailing address
58 N AVERRY CT, PALATINE, IL 60067-0918
(847) 602-3662
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.04309
IL
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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