Healthcare Provider Details

I. General information

NPI: 1306812177
Provider Name (Legal Business Name): JESSICA ABBEY BELL ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W GREEN ST
BENSENVILLE IL
60106-2008
US

IV. Provider business mailing address

444 FLINT TRL
CAROL STREAM IL
60188-1444
US

V. Phone/Fax

Practice location:
  • Phone: 630-860-6280
  • Fax:
Mailing address:
  • Phone: 630-665-1065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: