Individual
AMANDA KATHLEEN BAGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
680 N LAKE SHORE DR, SUITE 924, CHICAGO, IL 60611-4546
(312) 664-6848
(866) 954-5808
Mailing address
832 N WASHTENAW AVE, UNIT 2, CHICAGO, IL 60622-4429
(630) 346-1742
(866) 954-5808
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096002790
IL
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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