| NPI | 1366072555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN VANRADEN Assistant Ad/Head Athletic Trainer 630-829-6154 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |