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Individual

MRS. CARRIE C GROBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS,RD

Contact information

Practice address
211 S JACKSON AVE, POLO, IL 61064-1719
(815) 222-4236
Mailing address
211 S JACKSON AVE, POLO, IL 61064-1719
(815) 222-4236

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164002838
IL
133V00000X
Registered Dietitian

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
164002838
ILLINOIS LICENSE
IL
Enumeration date
04/01/2008
Last updated
06/27/2023
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