NPI 1023780673

Jessica Boudreau

Practitioner Registered Dietitian Bourbonnais, IL

Practice location

Address: 100 Fitness Dr, Bourbonnais, IL 60914-9584
Phone: (815) 936-6515

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 164.007714 (IL)

Other Dietitian, Registered providers in Illinois →

Registry record

NPI: 1023780673
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Oct 2021
Record last updated: 1 Oct 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.