Stephanie Marie Luebbe

Individual provider Active NPI Athletic Trainer · Hawthorn Woods, IL

NPI 1982118576 · NPPES record last updated Nov 19, 2017

Key facts

NPI
1982118576
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
30 Seneca Ave W
Hawthorn Woods, IL 60047
Phone
(847) 707-9517
NPI assigned
Nov 19, 2017
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

30 Seneca Ave W
Hawthorn Woods, IL 60047

Mailing address

30 Seneca Ave W
Hawthorn Woods, IL 60047-1919

Other providers in Hawthorn Woods, IL

All providers in Hawthorn Woods, IL · Athletic Trainer in Illinois

Sources for this page

Verify at the official NPI Registry.