Individual
JESSICA REPAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1 INGALLS DR, HARVEY, IL 60426-3558
(708) 915-5948
Mailing address
1 INGALLS DR, HARVEY, IL 60426-3558
(708) 915-5948
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164005982
IL
133V00000X
Registered Dietitian
37002375A
IN
Other
Enumeration date
06/09/2016
Last updated
09/17/2024
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