| NPI | 1730537267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE CUPP Dietitan 815-464-9734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 164.000250) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |