NPI 1124766803 · live from the CMS NPI Registry
Vida Agyeman-Badu, RDN, LDN
Dietitian, Registered in Richton Park, IL. National Provider Identifier 1124766803, active.
NPI record
| NPI | 1124766803 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 22817 East Dr, Richton Park, IL 60471 |
| Practice phone | 708-717-9968 |
| Enumerated | May 23, 2022 |
| Last updated | May 23, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 164004130 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.