Kathy M Petosky, RD is a
Dietitian, Registered based in East Moline, Illinois. Kathy M Petosky is licensed to practice in Illinois (license number 164005486) and her current practice location is
4721 8th St, Apt. 11211, East Moline, Illinois. She can be reached at her office (for appointments etc.) via phone at
(309) 792-4553.
NPI number for Kathy M Petosky is 1174890610 and her current mailing address is 4721 8th St, Apt. 11211, East Moline, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1174890610.
Healthcare Provider's Profile
Full Name | Kathy M Petosky |
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Gender | Female |
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Speciality | Dietitian, Registered |
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Location | 4721 8th St, East Moline, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1174890610
- Provider Enumeration Date: 11/29/2011
- Last Update Date: 11/29/2011
Medical Identifiers
Medical identifiers for Kathy M Petosky such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1174890610 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | 164005486 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kathy M Petosky is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kathy M Petosky, RD 4721 8th St, Apt. 11211, East Moline, IL 61244-5111 Ph: (309) 792-4553 | Kathy M Petosky, RD 4721 8th St, Apt. 11211, East Moline, IL 61244-5111 Ph: (309) 792-4553 |
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