Healthcare Provider Details

I. General information

NPI: 1629794961
Provider Name (Legal Business Name): RMF NUTRITION AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 DUNLAP CT
SAVOY IL
61874-9501
US

IV. Provider business mailing address

403 LAKE FALLS BLVD
SAVOY IL
61874-7474
US

V. Phone/Fax

Practice location:
  • Phone: 217-979-6009
  • Fax:
Mailing address:
  • Phone: 217-979-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. MELISSA ANNE SMITH
Title or Position: CEO-REGISTERED DIETITIAN
Credential: RDN, LDN
Phone: 217-979-6009