Individual
MARIE ELIZABETH FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
7 S HOSPITAL DR, MURPHYSBORO, IL 62966-3333
(618) 519-9200
(618) 687-1859
Mailing address
109 CALIFORNIA ST, PO BOX 577, CARTERVILLE, IL 62918-0577
(618) 519-9200
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164007111
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370966854002
—
IL
Enumeration date
07/18/2017
Last updated
07/18/2017
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