Individual
MS. SANDRA MARIE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDN
Contact information
Practice address
2262 W. 119TH PL., BLUE ISLAND, IL 60406-1123
(630) 865-2529
(708) 385-0882
Mailing address
2262 W. 119TH PL., 2262 W. 119THPL, BLUE ISLAND, IN 60406-1123
(630) 865-2529
(708) 385-0882
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
164.003956
IL
Other
Enumeration date
01/13/2011
Last updated
01/13/2011
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