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NPI Code Detail

MEDICARE: PAT SABINO MNT

MEDICARE: PAT SABINO MNT
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
1133V00000XRegistered Dietitian

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00034601OTHERILRAILROAD MEDICARE

General Provider Information

NPI Number : 1447366000
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAT SABINO MNT
Provider Business Mailing Address
First Line : 111 SPRING ST
Second Line :
City : STREATOR
State : IL
Zip : 61364-3332
Country : US
Telephone Number : 815-673-2311
Fax Number : 815-673-4646
Provider Business Practice Location Address
First Line : 111 SPRING ST
Second Line :
City : STREATOR
State : IL
Zip : 61364-3332
Country : US
Telephone Number : 815-673-2311
Fax Number : 815-673-4646
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 07/09/2007

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Directions to “ PAT SABINO MNT” Practice Location

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