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General NPI Number Information
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NPI Number | 1164570313
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Entity Type | Individual
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Provider Name | DEEPA DESHMUKH MPH,RD,LDN
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Gender | Female
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Dates
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Enumeration Date | 01/06/2007
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 3080 OGDEN AVE
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City | LISLE
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State | IL
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Zip | 60532-1691
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Country | US
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Telephone | 630-839-9296
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Fax |
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Provider Business Mailing Address
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Address Line | 1603 BARKEI DR
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City | BATAVIA
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State | IL
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Zip | 60510-8305
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Country | US
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Telephone | 630-699-2417
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 164004325
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License Number State | IL
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