Healthcare Provider Details

I. General information

NPI: 1992670061
Provider Name (Legal Business Name): AMANDA AUGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 N RANDALL RD
ELGIN IL
60123-2300
US

IV. Provider business mailing address

1425 N RANDALL RD
ELGIN IL
60123-2300
US

V. Phone/Fax

Practice location:
  • Phone: 224-783-3450
  • Fax:
Mailing address:
  • Phone: 224-783-3450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164.007504
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: