Individual
NICOLE C GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
839 W ROOSEVELT RD, ATHLETIC TRAINING, CHICAGO, IL 60608-1530
(312) 993-2043
Mailing address
3435 N ELAINE PL, APT #2R, CHICAGO, IL 60657-2077
(847) 668-5597
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003262
IL
Other
Enumeration date
09/27/2009
Last updated
09/19/2014
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