Individual
TARAH ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, ATC, CSCS,
Contact information
Practice address
5700 COLLEGE RD, LISLE, IL 60532-2851
(630) 829-6154
(630) 829-6169
Mailing address
5700 COLLEGE RD, LISLE, IL 60532-2851
(630) 829-6154
(630) 829-6169
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003007
IL
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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