Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TRACEY L. CICIRALE, RD,LDN
Active Sole ProprietorPediatric Nutrition · LOCKPORT, IL
Registration Details
- NPI Number
- 1851417273
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 21, 2007 (19.087790958981 yrs)
- Last Updated
- Aug 3, 2015
- Sole Proprietor
- Yes
Practice Information
- Address
-
16609 BLACKFOOT DRLOCKPORT, IL, 604411501Browse IL providers · Browse ZIP 60441
- Phone
- 8155884016
- Fax
- 8155884016
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
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.