Rachel E Bauman, RD

Individual provider Active NPI Registered Dietitian · Normal, IL

NPI 1811323975 · NPPES record last updated Sep 20, 2013

Key facts

NPI
1811323975
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
86011291 (IL)
Practice address
2200 Fort Jesse Rd
Suite 250
Normal, IL 61761-6286
Phone
(309) 268-0000
NPI assigned
Sep 20, 2013
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
86011291ILMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86011291 IL Yes

Addresses

Primary practice location

2200 Fort Jesse Rd
Suite 250
Normal, IL 61761-6286

Mailing address

2200 Fort Jesse Rd
Suite 250
Normal, IL 61761-6286
Phone (309) 268-0000

Other providers in Normal, IL

All providers in Normal, IL · Registered Dietitian in Illinois

Sources for this page

Verify at the official NPI Registry.