Individual
MRS. JACQUELINE ANN RICHARDSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5616 W 63RD ST, CHICAGO, IL 60638-5511
(773) 526-5239
(773) 526-5240
Mailing address
16908 S LECLAIRE, OAK FOREST, IL 60452
(708) 560-8634
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/23/2006
Last updated
07/08/2007
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