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

LicenseStateTypeSpecialty
164-005095ILMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

Other providers in Lake Forest, IL

All providers in Lake Forest, IL · Registered Dietitian in Illinois

Sources for this page

Verify at the official NPI Registry.