Individual
LAUREN KATE BIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.N
Contact information
Practice address
812 NORTH LOGAN AVENUE, PROVENA UNITED SAMARITANS MEDICAL - DIETARY DEPARTMENT, DANVILLE, IL 61832
(217) 443-5000
Mailing address
203 W COLUMBIA AVE APT 2, CHAMPAIGN, IL 61820-8649
(801) 717-0768
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001015297
IL
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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