Individual
NICOLE ANN O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 227-2274
Mailing address
4262 HONONEGAH RD, ROSCOE, IL 61073-6700
(779) 770-5089
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164006560
IL
133V00000X
Registered Dietitian
289629
WI
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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