Individual
MRS. JAMIE ALYSSA SHIFLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
6211 PARK AVE, DOWNERS GROVE, IL 60516-1917
(630) 886-6095
Mailing address
6211 PARK AVE, DOWNERS GROVE, IL 60516-1917
(630) 886-6095
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.004150
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164.004150
LICENSED DIETITIAN NUTRITIONIST
IL
Enumeration date
03/01/2019
Last updated
03/01/2019
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