| Colleen Michelle Takagishi, RD | |
|
2650 Ridge Ave, Division Of Hematology-oncology, Evanston, IL 60201-1718 | |
| (888) 909-5222 | |
| (847) 570-2336 |
| Full Name | Colleen Michelle Takagishi |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 2650 Ridge Ave, Evanston, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154488344 | NPI | - | NPPES |
| 164-000805 | Other | IL | IL STATE LIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 164-000805 (* (Not Available)) | Primary |
| Provider Name | Northshore University Healthsystem Faculty Practice Associates |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118 |
| Mailing Address | Practice Location Address |
|---|---|
| Colleen Michelle Takagishi, RD 2650 Ridge Ave, Evanston Hospital, Evanston, IL 60201-1718 Ph: (847) 570-1206 | Colleen Michelle Takagishi, RD 2650 Ridge Ave, Division Of Hematology-oncology, Evanston, IL 60201-1718 Ph: (888) 909-5222 |
Bogumila W Czaplinski, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2953 Central St Fl 1, Evanston, IL 60201 Phone: 847-869-9436 Fax: 847-869-9491 | |
Ms. Merle Rose Shapera, MS,RD,CDE,LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1572 Maple Avenue, Unit 604, Evanston, IL 60201 Phone: 708-415-2693 Fax: 708-763-1014 | |
Lakeside Digestion Pllc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 501 Sherman Ave, Evanston, IL 60202 Phone: 773-319-7319 | |
Mrs. Ilene Terri Wynn, R.D., L.D.N. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1560 Sherman Ave, Suite #400, Evanston, IL 60201 Phone: 847-869-1500 Fax: 847-869-1515 | |
Allison Wall, RD LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1011 Ashland Ave Fl 2, Evanston, IL 60202 Phone: 847-691-0442 | |
A New Leaf Natural Medicine Llc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 708 Church St, Evanston, IL 60201 Phone: 847-903-0503 | |
Elyse Roel, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2650 Ridge Ave, B106b, Evanston, IL 60201 Phone: 847-570-1987 |