Healthcare Provider Details

I. General information

NPI: 1922062173
Provider Name (Legal Business Name): JULIE ALBRECHT L.D.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 W 203RD ST STE 310
OLYMPIA FIELDS IL
60461-1182
US

IV. Provider business mailing address

1040 SIERRA DR SUITE 400
GREENWOOD IN
46143-7240
US

V. Phone/Fax

Practice location:
  • Phone: 708-679-2717
  • Fax: 708-679-2260
Mailing address:
  • Phone: 317-528-4253
  • Fax: 317-865-8319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164001207
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: