Lisa Ann Brandt, RD, LDN
Individual provider Active NPI Registered Dietitian · Sycamore, IL
NPI 1013354836 · NPPES record last updated Jun 3, 2013
Key facts
- NPI
- 1013354836
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 164.004217 (IL)
- Practice address
- 2700 Dekalb Ave
Sycamore, IL 60178-3127 - Phone
- (815) 756-6174
- Fax
- (815) 748-3784
- NPI assigned
- Jun 3, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.004217 | IL | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.004217 | IL | Yes |
Addresses
Primary practice location
2700 Dekalb Ave
Sycamore, IL 60178-3127
Mailing address
2700 Dekalb Ave
Sycamore, IL 60178-3127
Phone (815) 756-6174
Other providers in Sycamore, IL
- Braden Counseling Center, P.C.
- Jayne A. Braden
- Jason Evan Brand
- Lonn Edward Brander
- Carson Brandt
- Teah Brandt
- Sylvia S Bray
- Mary Katherine Brennan
- Doris M Brenner
- Broadstep Academy-Illinois Inc
All providers in Sycamore, IL · Registered Dietitian in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.