Individual
MR. RICHARD LANE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
2823 N CENTRAL PARK AVE APT 1F, CHICAGO, IL 60618-7326
(317) 364-2202
Mailing address
2823 N CENTRAL PARK AVE APT 1F, CHICAGO, IL 60618-7326
(317) 364-2202
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164008466
IL
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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