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General NPI Number Information
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NPI Number | 1902015605
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Entity Type | Individual
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Provider Name | KAREN REZABEK MMSC, RD, LDN
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1426 W WASHINGTON BLVD
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City | CHICAGO
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State | IL
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Zip | 60607-1821
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Country | US
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Telephone | 312-829-1424
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Fax | 312-850-8431
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Provider Business Mailing Address
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Address Line | 4520 HOME AVE
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City | BERWYN
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State | IL
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Zip | 60402-4318
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Country | US
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Telephone | 312-829-1424
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Fax | 312-850-8431
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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 | 420208
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License Number State | IL
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