Individual
ANDREA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD LDN CDE
Contact information
Practice address
800 E 55TH ST, CHICAGO, IL 60615-4906
(773) 834-2580
Mailing address
708 CORNFIELD RD, MATTESON, IL 60443-1404
(708) 720-5933
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
164.002406
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20020629
CERTIFIED DIABETES EDUCATOR
—
Enumeration date
06/01/2018
Last updated
06/01/2018
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