Individual
JACQUELINE M PRUSINSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5412 N MONT CLARE AVE, CHICAGO, IL 60656-1931
(773) 631-8616
Mailing address
5412 N MONT CLARE AVE, CHICAGO, IL 60656-1931
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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