Individual
JENNIFER SCULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
600 E 1ST ST, SPRING VALLEY, IL 61362-1512
(815) 664-1572
Mailing address
18789 2400 NORTH AVE, OHIO, IL 61349-9160
(815) 289-0936
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164003614
IL
Other
Enumeration date
05/22/2006
Last updated
07/22/2016
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