Organization
NUTRITION PERMISSION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE CONTEDUCA RDN (REGISTERED DIETITIAN)
(708) 539-4586
Entity
Organization
Contact information
Practice address
1152 BIRCH LN, WESTERN SPRINGS, IL 60558-2102
(708) 539-4586
Mailing address
1152 BIRCH LN, WESTERN SPRINGS, IL 60558-2102
(708) 539-4586
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/22/2023
Last updated
11/28/2023
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