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Individual

MISS PATRICIA ANN GAINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LDN

Contact information

Practice address
9600 GROSS POINT ROAD., SKOKIE, IL 60016-1752
(847) 933-6802
(847) 933-6807
Mailing address
9600 GROSS POINT ROAD., SKOKIE, IL 60016-1752
(847) 933-6802
(847) 933-6807

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.001196
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L98390
MEDICARE PART B
IL
Enumeration date
12/02/2010
Last updated
12/02/2010
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