MEDICARE: LAUREN NAVIN O'MEARA MS, RD, LDN

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
1	133V00000X	Registered Dietitian	164010980	IL

General Provider Information

NPI Number	:	1457171878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN NAVIN O'MEARA MS, RD, LDN

Provider Business Mailing Address
First Line	:	6543 FAIRMOUNT AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60516
Country	:	US
Telephone Number	:	630-456-5248
Fax Number	:

Provider Business Practice Location Address
First Line	:	6543 FAIRMOUNT AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60516
Country	:	US
Telephone Number	:	630-456-5248
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2024
Last Update Date	:	10/10/2024

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