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General NPI Number Information
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NPI Number | 1780038018
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Entity Type | Individual
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Provider Name | REBECCA EGGERS ATC
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Gender | Female
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Dates
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Enumeration Date | 04/23/2016
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Last Update Date | 04/23/2016
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Provider Practice Location Address
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Address Line | 1 UNIVERSITY PKWY
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City | ROMEOVILLE
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State | IL
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Zip | 60446-2200
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Country | US
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Telephone | 815-836-5694
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Fax |
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Provider Business Mailing Address
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Address Line | 301 EDINBURGH DR
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City | LOCKPORT
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State | IL
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Zip | 60441-3302
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Country | US
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Telephone | 630-220-4605
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 096001614
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License Number State | IL
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