NPI 1760463665 · live from the CMS NPI Registry
Rebecca A Antonacci, RD, CDE
Nutritionist, Nutrition, Education in Springfield, IL. National Provider Identifier 1760463665, active.
NPI record
| NPI | 1760463665 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nutritionist, Nutrition, Education 133NN1002X |
| Practice location | 415 N 9th St, Ste 6w162, Springfield, IL 62702 |
| Practice phone | 217-545-3848 |
| Mailing address | Po Box 19640, Springfield, IL 62794 |
| Enumerated | November 8, 2005 |
| Last updated | March 18, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | 164002929 (IL) |
| Nutritionist, Nutrition, Education primary | 133NN1002X | 164-002929 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.