Individual
MRS. PENNI JO HICKS-BLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.N.
Contact information
Practice address
11 E PLEASANT AVE, SANDWICH, IL 60548-1100
(815) 786-3719
Mailing address
11 E PLEASANT AVE, SANDWICH, IL 60548-1100
(815) 786-3719
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
IL
Other
Enumeration date
08/24/2007
Last updated
08/24/2007
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