Individual
MRS. ILENE TERRI WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.N.
Contact information
Practice address
1560 SHERMAN AVE, SUITE #400, EVANSTON, IL 60201-4818
(847) 869-1500
(847) 869-1515
Mailing address
2246 AVALON DR, BUFFALO GROVE, IL 60089-4682
(847) 913-1652
(847) 913-1758
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
IL
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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