Roth, Ellen

Roth, Ellen is an individual health care provider with primary practice located at 9 Heartland Dr Ste C , Bloomington IL 61704-7733. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Roth, Ellen can be contacted via phone (309) 663-7643.

Contact Information

Primary practice address
9 Heartland Dr Ste C Bloomington IL 61704-7733
Phone: (309) 663-7643
Fax: (309) 663-8359
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 164000669 Illinois

Profile Details

NPI number 1396141859
LBN Legal business name Roth, Ellen
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 11th, 2014
Last updated Nov 11th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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