Carol Ann Ackerman, RD LD
Individual provider Active NPI Registered Dietitian · Carmi, IL
NPI 1700096039 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1700096039
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 1530 County Road 1100 N
Carmi, IL 62821-5603 - Phone
- (618) 382-8818
- NPI assigned
- May 23, 2007
- 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 |
|---|---|---|---|
| 164001640 | IL | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | IL | Yes |
Addresses
Primary practice location
1530 County Road 1100 N
Carmi, IL 62821-5603
Mailing address
1530 County Road 1100 N
Carmi, IL 62821-5603
Phone (618) 382-8818
Other providers in Carmi, IL
All providers in Carmi, 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 8, 2007. 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.