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NPI Code Detail

MEDICARE: SARAH E. DEIG RDN, LDN

MEDICARE:   SARAH E. DEIG  RDN, 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
1133VN1004XPediatric Nutrition Registered Dietitian
2133VN1005XRenal Nutrition Registered Dietitian
3133VN1201XObesity and Weight Management Nutrition Registered Dietitian
4133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1639891567
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH E. DEIG RDN, LDN
Provider Business Mailing Address
First Line : 15315 W GLASFORD CANTON RD
Second Line :
City : GLASFORD
State : IL
Zip : 61533-9738
Country : US
Telephone Number : 309-360-5680
Fax Number :
Provider Business Practice Location Address
First Line : 420 NE GLEN OAK AVE
Second Line :
City : PEORIA
State : IL
Zip : 61603-3106
Country : US
Telephone Number : 309-624-2647
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2022
Last Update Date : 09/16/2022

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