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General NPI Number Information
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NPI Number | 1548989379
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Entity Type | Individual
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Provider Name | MELISSA BETANCE ND, CNS, LDN
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Gender | Female
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 8695 ARCHER AVE STE 5
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City | WILLOW SPRINGS
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State | IL
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Zip | 60480-1282
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Country | US
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Telephone | 630-550-7919
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Fax |
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Provider Business Mailing Address
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Address Line | 8354 HELEN CT
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-4910
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Country | US
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Telephone | 630-550-7919
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 164.008993
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License Number State | IL
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