Unknown Individual – Registered Dietitian, NPI 1619989555
Registered Dietitian
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
3307, Broadway Street, Mount Vernon, Jefferson County, Illinois, 62864, United States
STE 140
MOUNT VERNON, IL 628642347
Phone: (618) 244-7200
Fax: (618) 244-7274
Type: Location
RR 1 BOX 125B
DAHLGREN, IL 628289781
Phone: (618) 237-0148
Type: Mailing
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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Medicare Utilization (FFS)
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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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