Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
REBECCA A ANTONACCI, RD, CDE
ActiveNutrition, Education · SPRINGFIELD, IL
Registration Details
- NPI Number
- 1760463665
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 8, 2005 (20.490324507557 yrs)
- Last Updated
- Mar 18, 2010
- Licenses
-
164002929 (IL)164-002929 (IL)
Practice Information
- Address
-
415 N 9TH STSTE 6W162SPRINGFIELD, IL, 627025303Browse IL providers · Browse ZIP 62702
- Phone
- 2175453848
- Fax
- 2175454912
- Primary Specialty
-
Nutrition, Education
133NN1002X
- Additional Specialty
- Nutrition, Education
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.