Individual
MISS SUSAN BOETTCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
9409 MENARD AVE, OAK LAWN, IL 60453-2337
(708) 424-5909
Mailing address
9409 MENARD AVE, OAK LAWN, IL 60453-2337
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
363341
IL
133V00000X
Registered Dietitian
—
—
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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