Breanna Adams, ATC
Individual provider Active NPI Athletic Trainer · Fox Lake, IL
NPI 1104733575 · NPPES record last updated Aug 24, 2026
Key facts
- NPI
- 1104733575
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 096005623 (IL)
- Practice address
- 285 E Grand Ave
Fox Lake, IL 60020-1657 - Phone
- (847) 973-3113
- Fax
- (847) 587-1768
- NPI assigned
- Aug 24, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096005623 | IL | Yes |
Addresses
Primary practice location
285 E Grand Ave
Fox Lake, IL 60020-1657
Mailing address
217 Stafford Dr
Mundelein, IL 60060-2071
Phone (847) 973-3113
Other providers in Fox Lake, IL
- Absolute Wellness, LTD.
- Accelerated Rehabilitation Center of Kenosha LTD
- American Drug Stores LLC
- Amg Illinois LTD
- Russell E Anderson
- Joshua Tyler Armstrong
- Bailey Behavioral Health, PLLC
All providers in Fox Lake, IL · Athletic Trainer in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.