| Doctor Name: | MS. AMANDA M STUCKY |
| NPI Number: | 1871803387 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | |
| Business Practice Address: | 801 S Milwaukee Ave Libertyville, IL - 600483204 |
| Business Phone Number: | 4142906720 |
| Business Fax Number: | 4142906755 |
| Mailing Address: | 111 E Wisconsin Ave, Suite 2000 MILWAUKEE |
| State: | WI |
| Postal Code: | 532024815 |
| Phone Number: | 4142906720 |
| Fax Number: | 4142906755 |
| NPI Enumeration Date: | 10/18/2010 |
| NPI Last Update Date: | 08/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| 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 |