KELLY ANN WAGNER

CHICAGO, IL
NPI1689250953
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: IL  164.007063)
Additional Taxonomies133V00000X Dietitian, Registered
(Licence: NC  L006355)
Enumeration Date2021-03-18
Last Update Date2021-03-18
Business Address
KELLY ANN WAGNER RD
3530 N RETA AVE APT 2R
CHICAGO, IL 60657-6912
Phone number: 630-776-5461
Mailing Address
KELLY ANN WAGNER RD
3530 N RETA AVE APT 2R
CHICAGO, IL 60657-6912
Phone number: 630-776-5461