Maureen Pryatel Ham
Individual provider Active NPI Registered Dietitian · Bannockburn, IL
NPI 1346042744 · NPPES record last updated Mar 26, 2025
Key facts
- NPI
- 1346042744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 3000 Lakeside Dr
Bannockburn, IL 60015-1219 - Phone
- (845) 246-3029
- NPI assigned
- Mar 26, 2025
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Yes |
Addresses
Primary practice location
3000 Lakeside Dr
Bannockburn, IL 60015-1219
Mailing address
12 Latham Cir
Charleston, SC 29407-3439
Phone (440) 539-8716
Other providers in Bannockburn, IL
- James Edward Gruenewald
- Nina Gryglas
- Gurnee Radiology Center, LLC
- Jacqueline Haave
- Brandon Hafft
- Jeffrey Warren Hamilton
- Laura Hamilton
- Kevin C. Harang
- Laura Aline Harwood
- Bryan Louis Hersh
All providers in Bannockburn, 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 Mar 26, 2025. 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.