Individual
MS. JESSICA T LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
660 N WESTMORELAND RD, LAKE FOREST, IL 60045-1659
(847) 535-6806
(847) 535-7851
Mailing address
21137 W. YORKSHIRE DR, KILDEER, IL 60047-7929
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.004883
IL
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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