Individual
MRS. MADHU CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
338 CHICK EVANS ST, BOLINGBROOK, IL 60490-2075
(630) 849-9925
Mailing address
338 CHICK EVANS ST, BOLINGBROOK, IL 60490-2075
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
164003249
IL
133V00000X
Registered Dietitian
164003249
IL
Other
Enumeration date
06/28/2024
Last updated
06/28/2024
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