NPI 1578993424

Vincent John Di Renzo, MATATCCSCS

Practitioner Athletic Trainer McHenry, IL

Practice location

Address: 1783 Richmond Avenue, McHenry, IL 60050
Phone: (815) 385-0730
Fax: (815) 385-0572
Mailing address: 13468 Delaney Rd, Huntley, IL 60142-6334

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 096.003644 (IL)

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Registry record

NPI: 1578993424
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Nov 2013
Record last updated: 13 Nov 2013

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.