Kathleen Marie Abernathy, R.D., L.D.N.
Individual provider Active NPI Registered Dietitian · Lake Forest, IL
NPI 1295020063 · NPPES record last updated Jun 9, 2011
Key facts
- NPI
- 1295020063
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 164-005095 (IL)
- Practice address
- 660 N Westmoreland Rd
Lake Forest, IL 60045-1659 - Phone
- (847) 535-6330
- Fax
- (847) 535-7851
- NPI assigned
- Jun 9, 2011
- 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 |
|---|---|---|---|
| 164-005095 | IL | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164-005095 | IL | Yes |
Addresses
Primary practice location
660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Mailing address
660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 535-6330
Other names
- Kathleen Marie Anderson
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- Affiliated Urologists LTD
- Deepti Agarwal
All providers in Lake Forest, 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 9, 2011. 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.