Unknown Individual – Athletic Trainer, NPI 1780650424
Athletic Trainer
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1639, North Narragansett Avenue, Beat 2513, Austin, Chicago, Jefferson Township, Cook County, Illinois, 60302, United States
CHICAGO, IL 606393823
Phone: (708) 516-3761
Fax: (708) 456-1573
Type: Mailing
Ridgewood High School, 7500, West Montrose Avenue, Norridge, Norwood Park Township, Cook County, Illinois, 60706, United States
NORRIDGE, IL 607061153
Phone: (708) 456-4242
Fax: (708) 456-1573
Type: Location
NPPES updates history
- Provider•UpdatedMay 27, 2026
Fields: Entity type code, Gender code, First name, Middle name, Credential text, Name prefix text, Last name legal name, Enumeration date, Last update date, Deactivation date
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60639)
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