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NPI Code Detail

MEDICARE: ROSANNE WYGODNY HEALTH COACH

MEDICARE:   ROSANNE  WYGODNY  HEALTH COACH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133N00000XNutritionist

General Provider Information

NPI Number : 1114746450
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSANNE WYGODNY HEALTH COACH
Provider Business Mailing Address
First Line : 2128 W CORTEZ ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-3601
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2128 W CORTEZ ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-3601
Country : US
Telephone Number : 312-371-4485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2024
Last Update Date : 10/03/2024

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Directions to “ ROSANNE WYGODNY HEALTH COACH” Practice Location

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