Individual
LORI CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
547 S SCHMALE RD, CAROL STREAM, IL 60188-2451
(630) 462-7020
Mailing address
317 MALIBU DR, BOLINGBROOK, IL 60440-2042
(630) 677-7399
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096001583
LICENSE#
IL
Enumeration date
11/22/2006
Last updated
07/08/2007
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