Individual
ALEXANDRA OTWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
5962 N ELSTON AVE, CHICAGO, IL 60646-5540
(773) 774-2470
Mailing address
2300 N LINCOLN PARK W APT 416, CHICAGO, IL 60614-3252
(815) 218-8470
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.006655
IL
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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