NPI 1508638214 · live from the CMS NPI Registry
Mary Ann K Balaun
Dietitian, Registered in Naperville, IL. National Provider Identifier 1508638214, active.
NPI record
| NPI | 1508638214 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1116 Heatherton Dr, Naperville, IL 60563 |
| Practice phone | 817-789-5150 |
| Enumerated | October 25, 2023 |
| Last updated | October 25, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 86277907 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.