Margaret Roche Dudek, M.S., R.D., L.D.N.,

Individual provider Active NPI Registered Dietitian · Riverside, IL

NPI 1104993245 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104993245
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
Practice address
51 E Burlington St
Riverside, IL 60546-2124
Phone
(708) 442-0123
Fax
(708) 442-0930
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
164-000278ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Bounce Cuisine LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X IL Yes

Addresses

Primary practice location

51 E Burlington St
Riverside, IL 60546-2124

Mailing address

51 E Burlington St
Riverside, IL 60546-2124
Phone (708) 442-0123

Other providers in Riverside, IL

All providers in Riverside, IL · Registered Dietitian in Illinois

Sources for this page

Verify at the official NPI Registry.