Doctor Name: | TONYA HAGENBAUMER |
NPI Number: | 1033360136 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.R.D.L.D. |
License Number: | 806637 |
Business Practice Address: | 2025 S. Chicago Street Joliet, IL - 60436 |
Business Phone Number: | 8157262200 |
Business Fax Number: | |
Mailing Address: | 2025 S Chicago St, JOLIET |
State: | IL |
Postal Code: | 604363172 |
Phone Number: | 8157262200 |
Fax Number: | |
NPI Enumeration Date: | 10/07/2008 |
NPI Last Update Date: | 10/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 806637 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |