| Pathway Dietetics Llc | |
|
415 Machelle Dr Cary IL 60013-2399 | |
| (847) 354-5584 | |
| (888) 788-2497 |
| Full Name | Pathway Dietetics Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 415 Machelle Dr, Cary, Illinois |
| Authorized Official Name and Position | Gayle O Booth (OWNER/REGISTERED DIETITIAN) |
| Authorized Official Contact | 8473545584 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathway Dietetics Llc 415 Machelle Dr Cary IL 60013-2399 Ph: (847) 354-5584 | Pathway Dietetics Llc 415 Machelle Dr Cary IL 60013-2399 Ph: (847) 354-5584 |
| NPI Number | 1831493162 |
|---|---|
| Provider Enumeration Date | 12/30/2010 |
| Last Update Date | 03/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831493162 | NPI | - | NPPES |
| 164.001309 | Other | IL | STATE OF IL DIVISION OF PROFESSIONAL REGULATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 164.001309 (Illinois) | Primary |
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