Individual
ELIZABETH WATHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5510 S EAST ST STE H, INDIANAPOLIS, IN 46227-1939
(317) 924-8425
Mailing address
120 W 22ND ST, OAK BROOK, IL 60523-1557
(630) 573-5000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
37000429A
IN
133VN1005X
Renal Nutrition Registered Dietitian
Primary
37000429A
—
Other
Enumeration date
05/08/2025
Last updated
10/07/2025
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