Individual
JANIS TAAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
4550 MEMORIAL DR, MEDICAL OFFICE BUILDING ONE SUITE 360, BELLEVILLE, IL 62226-5372
(618) 239-9500
Mailing address
311 WESTFIELD DR, O FALLON, IL 62269-2728
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164-001437
IL
Other
Enumeration date
09/17/2009
Last updated
09/17/2009
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