Most Relevant Information
Provider Data
| NPI Number: | 1003053612 |
| Provider Name: | DANIELLE GENGO R.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 164.003918 |
Most Important Dates
| Enumeration Date: | 01/20/2009 |
| Last Updated: | 08/29/2012 |
Provider Practice Location
3249 OAK PARK AVE
BERWYN
IL
604023429
Practice Location Phone/Fax
| Phone: | 7087833077 |
| Fax: |
Provider Mailing Location
3249 OAK PARK AVE
BERWYN
IL
604023429
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |