Individual
RORY CAITLIN CUSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6125 N MEADE AVE, CHICAGO, IL 60646-3828
(312) 806-2850
Mailing address
6125 N MEADE AVE, CHICAGO, IL 60646-3828
(312) 806-2850
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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