| Doctor Name: | STACI MICHELLE VETROVSKY |
| NPI Number: | 1154313427 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD, LDN |
| License Number: | |
| Business Practice Address: | 353 E Burlington St Suite 202 Riverside, IL - 605462189 |
| Business Phone Number: | 7084426006 |
| Business Fax Number: | |
| Mailing Address: | 2720 S Highland Ave, Apt 364 LOMBARD |
| State: | IL |
| Postal Code: | 601485302 |
| Phone Number: | 8474202042 |
| Fax Number: | |
| NPI Enumeration Date: | 08/22/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | |
| 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 |