Individual
TRACEY L. CICIRALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LDN
Contact information
Practice address
16609 BLACKFOOT DR, LOCKPORT, IL 60441-1501
(815) 588-4016
(815) 588-4016
Mailing address
16609 BLACKFOOT DR, LOCKPORT, IL 60441-1501
(815) 588-4016
(815) 588-4016
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
03/21/2007
Last updated
08/03/2015
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