Raymond Jerome Stadt, ATC
NPI #1164435657 in Blue Island, Illinois
Provider Information
- NPI Number
- 1164435657
- Entity Type
- Individual
- Name
- Raymond Jerome Stadt, ATC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Aug 14, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 12700 SACRAMENTO AVE
- City
- Blue Island
- State
- Illinois
- ZIP Code
- 60406-1822
- Phone
- (708) 597-6300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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