Individual
AMY CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1114 LAKE ST, OAK PARK, IL 60301-1002
(708) 383-1114
Mailing address
1114 LAKE ST, OAK PARK, IL 60301-1002
(708) 383-1114
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164006342
IL
Other
Enumeration date
05/07/2015
Last updated
09/29/2020
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