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Individual

ANNA ROSA FASO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LDN

Contact information

Practice address
3 ERIE CT, OAK PARK, IL 60302-2519
(708) 383-6200
Mailing address
4930 N AUSTIN AVE APT 2, CHICAGO, IL 60630-2509
(773) 503-3807

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164010279
IL

Other

Enumeration date
05/10/2024
Last updated
05/10/2024
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