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NPI Code Detail

MEDICARE: MS. KAREN ANN WATT R.D.

MEDICARE: MS. KAREN ANN WATT R.D.
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 Dietitian164.004970IL

General Provider Information

NPI Number : 1841441607
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAREN ANN WATT R.D.
Provider Business Mailing Address
First Line : 107 TREMONT ST
Second Line :
City : HOPEDALE
State : IL
Zip : 61747-7525
Country : US
Telephone Number : 309-449-3321
Fax Number : 309-449-4016
Provider Business Practice Location Address
First Line : 107 TREMONT ST
Second Line :
City : HOPEDALE
State : IL
Zip : 61747-7525
Country : US
Telephone Number : 309-449-3321
Fax Number : 309-449-4016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2008
Last Update Date : 10/30/2008

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Directions to “ MS. KAREN ANN WATT R.D.” Practice Location

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