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NPI 1619851482

NPI 1619851482 : ELIZABETH KEANE RD, LDN : PALATINE, IL

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General NPI Number Information
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    NPI Number           |    1619851482
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    Entity Type          |    Individual 
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    Provider Name        |    ELIZABETH KEANE RD, LDN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/04/2025
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    Last Update Date     |    12/18/2025
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Provider Practice Location Address
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    Address Line         |    1185 N STERLING AVE APT 204 
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    City                 |    PALATINE
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    State                |    IL
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    Zip                  |    60067-1942
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    Country              |    US
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    Telephone            |    224-830-3250
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1185 N STERLING AVE APT 204 
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    City                 |    PALATINE
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    State                |    IL
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    Zip                  |    60067-1942
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    Country              |    US
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    Telephone            |    224-830-3250
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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       |    164.022291
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    License Number State |    IL
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