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

BENJAMIN ALEXANDER BLACK, ATC

Active

BENJAMIN ALEXANDER BLACK, ATC is a Athletic Trainer healthcare provider located in WILLOW BROOK, Illinois. NPI 1699751396 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · WILLOW BROOK, IL

Registration Details

NPI Number
1699751396
Provider Type
Individual
Gender
Male
NPI Issued
Dec 15, 2005 (20.628590284479 yrs)
Last Updated
Jul 8, 2007
License
96002214 (IL)

Practice Information

Address
207 63RD ST
ATHLETICO
WILLOW BROOK, IL, 605272147
Browse IL providers · Browse ZIP 60527
Phone
6302300900
Primary Specialty
Athletic Trainer
2255A2300X

Other Athletic Trainer Providers in WILLOW BROOK, IL

Name Credential NPI
MR. JAMES JOHN ALLIVATO JR. LAT, ATC 1942200266
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.