Individual
SAMANTHA GALICIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3231 W 66TH PL, CHICAGO, IL 60629-3425
(773) 540-3355
Mailing address
3231 W 66TH PLACE, CHICAGO, IL 60629
(773) 540-3355
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096031216
—
IL
Enumeration date
08/03/2017
Last updated
07/21/2022
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