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
| License | State | Type | Specialty |
|---|---|---|---|
| 86011291 | IL | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Normal, 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 Sep 20, 2013. 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.