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Individual

JULIE ALBRECHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.D.N.

Contact information

Practice address
3700 W 203RD ST STE 310, OLYMPIA FIELDS, IL 60461-1182
(708) 679-2717
(708) 679-2260
Mailing address
1040 SIERRA DR, SUITE 400, GREENWOOD, IN 46143-7240
(317) 528-4253
(317) 865-8319

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164001207
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
164001207
LICENSED DIETITIAN NUTRIT
IL
01
460860
CDR REGISTRATION ID NUMBE
IL
01
4673170001
DMERC
IL
01
DS3884
MEDICARE RAILROAD PTAN
IL
01
IL5686053
MEDICARE PTAN
IL
Enumeration date
04/14/2006
Last updated
02/26/2019
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