NPI 1093241887

Michaela Elizabeth Desantis, ATC

Practitioner Athletic Trainer Charleston, IL

Practice location

Address: 600 Lincoln Ave, Charleston, IL 61920-3011
Phone: (217) 581-3811

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 096004270 (IL)

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Registry record

NPI: 1093241887
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 May 2017
Record last updated: 11 May 2017

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.