Most Relevant Information
Provider Data
| NPI Number: | 1003423229 |
| Provider Name: | SUSANNAH MARIE BALDOCK MS, MPH, RD, LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/30/2020 |
| Last Updated: | 09/30/2020 |
Provider Practice Location
18N163 HIDDEN HILLS TRL
WEST DUNDEE
IL
601189531
Practice Location Phone/Fax
| Phone: | 6302045773 |
| Fax: |
Provider Mailing Location
18N163 HIDDEN HILLS TRL
WEST DUNDEE
IL
601189531
Provider Mailing Phone/Fax
| Phone: | 6302045773 |
| Fax: |