Lynn Bachelder

Individual provider Active NPI Registered Dietitian · Galesburg, IL

NPI 1760876007 · NPPES record last updated Mar 25, 2015

Key facts

NPI
1760876007
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
164003466 (IL)
Practice address
1975 National Blvd
Galesburg, IL 61401-1488
Phone
(309) 344-1100
Fax
(309) 344-2063
NPI assigned
Mar 25, 2015
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
164003466ILMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164003466 IL Yes

Addresses

Primary practice location

1975 National Blvd
Galesburg, IL 61401-1488

Mailing address

1975 National Blvd
Galesburg, IL 61401-1488
Phone (309) 344-1100

Other providers in Galesburg, IL

All providers in Galesburg, IL · Registered Dietitian in Illinois

Sources for this page

Verify at the official NPI Registry.