NPI 1083862841

Matthew Scott Repa, ATC

Practitioner Athletic Trainer Glenview, IL

Practice location

Address: 2401 Ravine Way Suite 100, Glenview, IL 60025-7645
Phone: (847) 724-4791
Mailing address: 9326 Kedvale Ave, Skokie, IL 60076-1421

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 096.002602 (IL)

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Registry record

NPI: 1083862841
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Sep 2008
Record last updated: 5 Sep 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.