NPI 1033356852

Jessica T Larson, RDLDN

Practitioner Registered Dietitian Lake Forest, IL

Practice location

Address: 660 N Westmoreland Rd, Lake Forest, IL 60045-1659
Phone: (847) 535-6806
Fax: (847) 535-7851
Mailing address: 21137 W. Yorkshire Dr, Kildeer, IL 60047-7929

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 164.004883 (IL)

Other Dietitian, Registered providers in Illinois →

Registry record

NPI: 1033356852
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Jan 2009
Record last updated: 15 Jan 2009

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.