Most Relevant Information
Provider Data
| NPI Number: | 1003498643 |
| Provider Name: | AMY LEE KACZOR RDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 86104655 |
Most Important Dates
| Enumeration Date: | 04/23/2021 |
| Last Updated: | 04/23/2021 |
Provider Practice Location
1776 GLOUCESTER CT APT D
WHEATON
IL
601898450
Practice Location Phone/Fax
| Phone: | 6306709998 |
| Fax: |
Provider Mailing Location
1776 GLOUCESTER CT APT D
WHEATON
IL
601898450
Provider Mailing Phone/Fax
| Phone: | 6306709998 |
| Fax: |