Healthcare Provider Details

I. General information

NPI: 1659113850
Provider Name (Legal Business Name): AMY L HOOK RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 06/10/2024
Certification Date: 06/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11179 ARGO FAY RTE
THOMSON IL
61285-7444
US

IV. Provider business mailing address

11179 ARGO FAY RTE
THOMSON IL
61285-7444
US

V. Phone/Fax

Practice location:
  • Phone: 563-212-7919
  • Fax:
Mailing address:
  • Phone: 563-212-7919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: