Lisa Marie Micetich in Woodridge - Dietitian, Registered
Lisa Marie Micetich - NPI 1568682284
Lisa Marie Micetich is a Dietitian, Registered in Woodridge, Illinois. Lisa Marie Micetich practices all healthcare services and medical treatments related to Dietitian, Registered. The NPI Number for Lisa Marie Micetich is 1568682284. The last update date is 2007-07-08.
Lisa Marie Micetich's current location address is 9015 Witham Ln, Woodridge, Illinois. You can contact this provider via phone number 7082295429 and fax number 7082295308. The mailing address for Lisa Marie Micetich is 9015 Witham Ln, Woodridge, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lisa Marie Micetich |
|---|---|
| Address | 9015 Witham Ln, Woodridge, Illinois |
| Phone Number | 7082295429 |
| Fax Number | 7082295308 |
| Sole Proprietor | Y |
| Credentials | R.D. |
NPI Number Detail
| NPI Number | 1568682284 |
|---|---|
| Provider Enumeration Date | 2007-04-26 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 9015 Witham Ln |
|---|---|
| City | Woodridge |
| State | Illinois (IL) |
| Post Code | 605177621 |
| Phone Number | 7082295429 |
| Fax Number | 7082295308 |
Provider's Primary Taxonomy Detail
| Speciality | Dietitian, Registered |
|---|---|
| Taxonomy | 133V00000X |
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Definition: A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of |
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What is the unique 10-digit identifier code assigned to Lisa Marie Micetich by the Centers for Medicare & Medicaid Services?
The Lisa Marie Micetich has been issued the NPI (National Provider Identifier) 1568682284 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Lisa Marie Micetich located?
The Lisa Marie Micetich is located at 9015 Witham Ln, Woodridge, IL 605177621.
What is Lisa Marie Micetich's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Lisa Marie Micetich is Dietitian, Registered, and the corresponding taxonomy classification code for this specialized field is 133V00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1568682284 to Lisa Marie Micetich?
The Centers for Medicare & Medicaid Services originally issued the 1568682284 to Lisa Marie Micetich on 2007-04-26.
As of what date was the information regarding Lisa Marie Micetich, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Lisa Marie Micetich, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.