Individual
ANGELA MARIE PRUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
550 W OGDEN AVE, HINSDALE, IL 60521-3186
(630) 863-2011
Mailing address
309 STRATFORD PL APT 31, BLOOMINGDALE, IL 60108-2382
(630) 863-2011
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004319
IL
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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