JACI ELIZABETH LAKE (RD) – Registered Dietitian, NPI 1235776816

JACI ELIZABETH LAKE (RD) is a healthcare provider. based in Mount vernon, Illinois. specializing in Registered Dietitian. They hold the professional credentials RD. They hold a License No. 164.006872 (IL). The NPI Number for JACI ELIZABETH LAKE (RD) is 1235776816

Main info

Female
Name
JACI ELIZABETH LAKE (RD)
NPI
1235776816
Phone
(618) 436-8114
Address
5 Good Samaritan Way
Enumeration Date
3 December 2019
Last Update Date
3 December 2019
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

Provider Addresses for JACI ELIZABETH LAKE (RD)

  • 5 Good Samaritan Way

    Mount Vernon, IL 628642402

    Phone: (618) 436-8114

    Type: Location

  • 7843 COOLIDGE RD

    OAKDALE, IL 622681415

    Phone: (618) 978-3551

    Type: Mailing

  • 432 N PLEASANT AVE

    CENTRALIA, IL 628013006

    Phone: (618) 436-8114

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62864)

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Reviews

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Frequently asked questions

What identifier follows JACI ELIZABETH LAKE (RD) across health systems?
The NPI 1235776816 uniquely identifies JACI ELIZABETH LAKE (RD) in U.S. healthcare data.
Quick check: is JACI ELIZABETH LAKE (RD) active?
Public NPPES data shows JACI ELIZABETH LAKE (RD) with an active NPI status right now.
Which specialty label fits JACI ELIZABETH LAKE (RD)?
NPPES ties JACI ELIZABETH LAKE (RD) to Registered Dietitian in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to JACI ELIZABETH LAKE (RD)?
JACI ELIZABETH LAKE (RD) shows a connection to Mount Vernon, Illinois in registry-derived data.
Why is information missing for JACI ELIZABETH LAKE (RD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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