Individual
ANNE M LIETZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
333 MADISON ST, JOLIET, IL 60435-8200
(815) 723-7133
Mailing address
1419 GREEN TRAILS DR, PLAINFIELD, IL 60586-7613
(815) 577-8173
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00152372
RAILROAD MEDICARE
IL
Enumeration date
04/21/2006
Last updated
07/08/2007
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