Individual
MRS. WANDA DANIELS PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-2932
Mailing address
993 KNOWLES RD, GURNEE, IL 60031-5627
(847) 223-5033
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164004621
IL
133V00000X
Registered Dietitian
750
TN
Other
Enumeration date
08/05/2006
Last updated
05/07/2008
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