Individual
KAMMY JANE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., ATC
Contact information
Practice address
1200 N STADIUM DR, YORDON CENTER NORTHERN ILLINOIS UNIVERSITY SPORTS MEDIC, DEKALB, IL 60115-6079
(815) 762-7240
(815) 753-2415
Mailing address
723 MERIDIAN CT, DEKALB, IL 60115-8275
(815) 762-7240
(815) 753-2415
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002046
IL
Other
Enumeration date
02/02/2009
Last updated
09/28/2009
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