Individual
MRS. ROBERTA HELEN CLARKE JENERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDN
Contact information
Practice address
980 N MICHIGAN AVE, SUITE 1400, CHICAGO, IL 60611-4501
(312) 988-4850
(847) 430-3108
Mailing address
925 N PROSPECT AVE, PARK RIDGE, IL 60068-2668
(847) 508-7536
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164001957
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548498777
NPPES
IL
Enumeration date
04/29/2015
Last updated
04/29/2015
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