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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MICHAEL PATRICK PENDERGAST SR., ATC

Active

MICHAEL PATRICK PENDERGAST SR., ATC is a Athletic Trainer healthcare provider located in MACOMB, Illinois. NPI 1275598161 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · MACOMB, IL

Registration Details

NPI Number
1275598161
Provider Type
Individual
Gender
Male
NPI Issued
Apr 20, 2006 (20.28121421606 yrs)
Last Updated
Jul 8, 2007

Practice Information

Address
WESTERN ILLINOS UNIVERSITY ATHLETIC DEPT.
ONE UNIV. CIRCLE
MACOMB, IL, 61455
Browse IL providers · Browse ZIP 61455
Phone
3092081253
Primary Specialty
Athletic Trainer
2255A2300X

Other Athletic Trainer Providers in MACOMB, IL

Name Credential NPI
RENEE L POLUBINSKY ATC, CSCS 1134193691
JENNIFER M PLOS ATC 1376511949
MR. KELLY JAY MCBRIDE ATC/L 1467412452
MISS AMY BECKMAN MS, ATC, CSCS 1730116591
MR. CHAD C CERULLO MS, LAT, ATC 1932252319
MOLLY LYNN ANDERSON 1407079429
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.