NPI 1952704504

Heather Sue Illg, RDLD

Practitioner Registered Dietetic Technician Urbandale, IA

Practice location

Address: 8701 Douglas Ave, Urbandale, IA 50322-2200
Phone: (515) 251-5284
Fax: (515) 270-2227

Registered specialties

Registered Dietetic Technician Primary

Dietary & Nutritional Service Providers Taxonomy 136A00000X Licence 01342 (IA)

Other Dietetic Technician, Registered providers in Iowa →

Registry record

NPI: 1952704504
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Sep 2014
Record last updated: 26 Sep 2014

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.