Individual
LEAH MAE PATAKI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.A., ATC, CWT
Contact information
Practice address
3301 N MULFORD RD, ROCKFORD, IL 61114-5640
(815) 921-3821
(815) 921-3829
Mailing address
7080 SUE CT, LOVES PARK, IL 61111-5369
(815) 316-8647
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/15/2006
Last updated
07/08/2007
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