Doctor Name: | MRS. SARA E EADES WADE |
NPI Number: | 1740558428 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, RD, LDN |
License Number: | 164.005589 |
Business Practice Address: | 1000 Medical Center Dr Monticello, IL - 618562116 |
Business Phone Number: | 2177621904 |
Business Fax Number: | 2177621905 |
Mailing Address: | 1020 E 1150 North Rd, BEMENT |
State: | IL |
Postal Code: | 618133510 |
Phone Number: | 2178409464 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2011 |
NPI Last Update Date: | 12/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 164.005589 |
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 |