Individual
JENNIFER LYNN PANICKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D
Contact information
Practice address
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3204
(847) 990-5283
Mailing address
1521 JOHNSON DRIVE, APT 823, BURFFALO GROVE, IL 60089
(847) 990-5283
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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