NPI 1316459001 · live from the CMS NPI Registry
Dua Aldasouqi, MA, RDN
Dietitian, Registered in Champaign, IL. National Provider Identifier 1316459001, active.
NPI record
| NPI | 1316459001 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 618 Corey Ln, Champaign, IL 61822 |
| Practice phone | 314-833-9694 |
| Mailing address | Po Box 3852, Champaign, IL 61826 |
| Enumerated | November 2, 2017 |
| Last updated | November 2, 2017 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 1011589 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.