Individual
MRS. STEPHANIE LYNN BOOTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
670 CRESCENT BLVD, GLEN ELLYN, IL 60137-4286
(630) 942-7570
(630) 469-8608
Mailing address
1592 TIMBER TRL, WHEATON, IL 60187-6143
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/22/2006
Last updated
07/30/2007
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