Individual
KERRY A HACKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4450 WILSON AVE, DOWNERS GROVE, IL 60515-2643
(952) 210-0023
Mailing address
4450 WILSON AVE, DOWNERS GROVE, IL 60515-2643
(952) 210-0023
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164006253
IL
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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