| NPI | 1831493162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE O BOOTH Owner/Registered Dietitian 847-354-5584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 164.001309) |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2015-03-07 |