Rita Brongiel, RD, LDN
Individual provider Active NPI Registered Dietitian · Blue Island, IL
NPI 1376774232 · NPPES record last updated Jul 27, 2009
Key facts
- NPI
- 1376774232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 164.000594 (IL)
- Practice address
- 12935 Gregory St
Blue Island, IL 60406-2428 - Phone
- (708) 597-2000
- Fax
- (708) 824-4654
- NPI assigned
- Jul 27, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 164.000594 | IL | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.000594 | IL | Yes |
Addresses
Primary practice location
12935 Gregory St
Blue Island, IL 60406-2428
Mailing address
12935 Gregory St
Blue Island, IL 60406-2428
Phone (708) 597-2000
Other providers in Blue Island, IL
- Andrea R. Boyd
- James Branch
- Ann Brekke
- Bright Smile Family Dental
- Bright Smile Family Dental
- Melissa R Brousil
- Gina Brown
- Frank M Bucki Jr.
- Darlene Jo Buis
- Jeffrey Bzdusek
All providers in Blue Island, 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 Jul 27, 2009. 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.