- Practice location
- 708 Church St, Evanston, IL 60201-3875
- Phone
- 847-903-0503
- Fax
- —
- Last updated
- October 10, 2020
A New Leaf Natural Medicine LLC is a healthcare organization based in Evanston, IL. A New Leaf Natural Medicine LLC practices in Evanston, IL. The NPI Number for A New Leaf Natural Medicine LLC is 1104306240 and holds a License No. 1640006979 (IL). The current practice location address for A New Leaf Natural Medicine LLC is 708 Church St, Evanston, IL 60201-3875 and can be reached out via phone at 847-903-0503.
Provider Profile Details
- NPI Number
- 1104306240
- Provider Name
- A New Leaf Natural Medicine LLC
- Provider Entity Type
- Organization
- Address
- 708 Church St, Evanston, IL 60201-3875
- Phone Number
- 847-903-0503
- Primary Taxonomy
- Dietitian, Registered · 133V00000X
- Organization Subpart
- No
- Authorized Official
- Dr. Bonnie Lynn Brock, MPH, RD, LDN, ND · Sole Member · 847-903-0503
- Provider Enumeration Date
- August 17, 2018
- Last Update Date
- October 10, 2020
- Certification Date
- October 10, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 708 Church St
Evanston, IL 60201-3875 - City
- Evanston
- State
- Illinois
- Zip
- 60201-3875
- Phone Number
- 847-903-0503
Provider Business Mailing Address Details
- Address
- 1420 W Hutchinson St Apt 3N
Chicago, IL 60613-1343 - City
- Chicago
- State
- IL
- Zip
- 60613-1343
- Phone Number
- 773-331-1740
License Information
- License Number
- 1640006979
- License State
- IL
- Taxonomy
- Dietitian, Registered · 133V00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dietitian, Registered providers near Evanston, IL
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- Adrienne L Adams, MDPsychiatry & Neurology, Child & Adolescent Psychiatry · NPI 1578661781
- Ozaz H AbdallaCounselor, Mental Health · NPI 1154077477
- Syed M Alavi, MDFamily Medicine · NPI 1366837023
- Access Community Health NetworkClinic/Center, Federally Qualified Health Center (FQHC) · NPI 1194179721
Frequently Asked Questions
What is the NPI number of A New Leaf Natural Medicine LLC?
The NPI number of A New Leaf Natural Medicine LLC is 1104306240. It was assigned on August 17, 2018 and is currently active in the NPPES registry.
What is the specialty of A New Leaf Natural Medicine LLC?
A New Leaf Natural Medicine LLC is registered under the primary taxonomy Dietitian, Registered (code 133V00000X), licensed in IL under license number 1640006979.
Where does A New Leaf Natural Medicine LLC practice?
The practice location is 708 Church St, Evanston, IL 60201-3875. The office can be reached at 847-903-0503 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1104306240 directly on the NPPES registry website.