Provider Demographics
NPI:1316051972
Name:STRAUSBERGER, AMANDA L (ATC/L)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:STRAUSBERGER
Suffix:
Gender:F
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 WHITE OAK WAY
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-9244
Mailing Address - Country:US
Mailing Address - Phone:630-605-8419
Mailing Address - Fax:
Practice Address - Street 1:2966 US HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8362
Practice Address - Country:US
Practice Address - Phone:630-554-8888
Practice Address - Fax:630-554-8808
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL960020702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer