WILD TABLE PLLC

CHICAGO, IL
NPI1174327209
Entity TypeOrganization
Authorized ContactINGRID CLARK
Registered Dietitian
608-438-1612
Organization Subpart ?No
Primary Taxonomy133V00000X Dietitian, Registered
Enumeration Date2025-04-01
Last Update Date2025-04-01
Business Address
WILD TABLE PLLC
740 N OGDEN AVE APT 4
CHICAGO, IL 60642-7063
Phone number: 608-438-1612
Mailing Address
WILD TABLE PLLC
1842 N ALBANY AVE
CHICAGO, IL 60647-5073
Phone number: 608-438-1612
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