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Individual

KEISHA MICHELLE GASKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD

Contact information

Practice address
645 S CENTRAL AVE, CHICAGO, IL 60644-5059
(773) 633-9991
Mailing address
102 HIGHPOINT DR, APT. 205, ROMEOVILLE, IL 60446-3897
(815) 641-7983

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164004398
IL

Other

Enumeration date
04/11/2013
Last updated
04/11/2013
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