Most Relevant Information
Provider Data
| NPI Number: | 1003459199 |
| Provider Name: | CONNIE LYNN MACHETTA RDN, LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 164000596 |
Most Important Dates
| Enumeration Date: | 10/22/2019 |
| Last Updated: | 10/22/2019 |
Provider Practice Location
1900 SILVER CROSS BLVD
NEW LENOX
IL
604519509
Practice Location Phone/Fax
| Phone: | 8154740458 |
| Fax: | 8153002706 |
Provider Mailing Location
1900 SILVER CROSS BLVD
NEW LENOX
IL
604519509
Provider Mailing Phone/Fax
| Phone: | 8153001078 |
| Fax: | 8153002076 |