Individual
MR. CHRIS M. GELDERNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS RD LDN
Contact information
Practice address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
(217) 223-9716
Mailing address
1601 S 24TH ST APT 410, QUINCY, IL 62301-6965
(630) 209-4390
(217) 223-9716
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
164005594
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00132061
BLUE CROSS BLUE SHIELD ILLINOIS
IL
Enumeration date
03/20/2012
Last updated
05/22/2012
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