| Lisa Schrader, MS, RDN, LDN | |
|
733 Chicago Ave Unit 505, Evanston, IL 60202-2381 | |
| (630) 779-0120 | |
| Not Available |
| Full Name | Lisa Schrader |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 733 Chicago Ave Unit 505, Evanston, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740807437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 164.007414 (Illinois) | Primary |
| Provider Name | Nourish, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1558097824 PECOS PAC ID: 1557724937 Enrollment ID: O20230901000471 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Schrader, MS, RDN, LDN 733 Chicago Ave Unit 505, Evanston, IL 60202-2381 Ph: (630) 779-0120 | Lisa Schrader, MS, RDN, LDN 733 Chicago Ave Unit 505, Evanston, IL 60202-2381 Ph: (630) 779-0120 |
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