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Individual

EILEEN HOAG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD, LD

Contact information

Practice address
105 S MISSOURI AVE, BELLEVILLE, IL 62220-3867
(618) 444-3030
Mailing address
105 S MISSOURI AVE, BELLEVILLE, IL 62220-3867
(618) 444-3030

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1399
SC
133V00000X
Registered Dietitian
Primary
164.002052
IL
133V00000X
Registered Dietitian
1820
TN
133V00000X
Registered Dietitian
2004029842
MO
133V00000X
Registered Dietitian
L004676
NC

Other

Enumeration date
12/08/2016
Last updated
12/08/2016
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