Individual
MR. LORENZO ANTONIO CORTEZ VELAZCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(224) 814-9456
Mailing address
1416 BEVERLY DR, ROUND LAKE BEACH, IL 60073-1509
(224) 814-9456
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004610
IL
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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