Amanda Lynn Anderson, ATC
Individual provider Active NPI Athletic Trainer · Glenview, IL
NPI 1457361990 · NPPES record last updated Dec 7, 2011
Key facts
- NPI
- 1457361990
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 096.001971 (IL)
- Practice address
- 4000 W Lake Ave
Glenview, IL 60026-1239 - Phone
- (847) 486-4627
- NPI assigned
- Aug 8, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.001971 | IL | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.001971 | IL | Yes |
Addresses
Primary practice location
4000 W Lake Ave
Glenview, IL 60026-1239
Mailing address
319 W Riverside Dr
Lakemoor, IL 60051-8774
Phone (847) 486-4627
Other providers in Glenview, IL
- Roma Amin
- Kelly Amrhein
- Amy Fayazrad & Associates, PC
- Nandita Anand
- Anderson Dental Associates LTD
- Emily Taxe Anderson
- Miranda Anderson
- Andrea Fullerton LCSW PLLC
- Shelly Andrews
- Evelyn Lizbeth Angulo
All providers in Glenview, 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 Dec 7, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.