Individual
BRIANNA CATHERINE VAN MIEGHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
625 W MADISON ST APT 911, CHICAGO, IL 60661-2414
(309) 385-2549
Mailing address
625 W MADISON ST APT 911, CHICAGO, IL 60661-2414
(309) 385-2549
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004735
IL
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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