Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. RICHENEL SAMUEL ELLECOM, PSY.D; DR.P.H
Active Sole ProprietorDR. RICHENEL SAMUEL ELLECOM, PSY.D; DR.P.H is a Registered Dietitian healthcare provider located in WILLOW BROOK, Illinois. NPI 1063406569 is currently active in the NPPES registry. Verify at CMS.
Registered Dietitian · WILLOW BROOK, IL
Registration Details
- NPI Number
- 1063406569
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 12, 2005 (20.952436913006 yrs)
- Last Updated
- Oct 27, 2008
- Licenses
-
71-5240 (IL)20040961A (IN)164-2611 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
621 PLAINFIELD RDSUITE 110WILLOW BROOK, IL, 605275343Browse IL providers · Browse ZIP 60527
- Phone
- 6306541377
- Fax
- 6306542575
- Primary Specialty
-
Registered Dietitian
133V00000X
- Additional Specialty
- Clinical Neuropsychologist
- Additional Specialty
- Registered Dietitian
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.