Individual
LAUREN GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(708) 783-3077
Mailing address
514 OAKTON ST, ELK GROVE VILLAGE, IL 60007-1729
(224) 558-3892
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164007182
IL
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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