| Mrs Kelly Wynne Minarick, RD, RDN, LDN | |
|
650 Warrenville Rd Ste 100, Lisle, IL 60532-4315 | |
| (847) 318-3013 | |
| (833) 290-5413 |
| Full Name | Mrs Kelly Wynne Minarick |
|---|---|
| Gender | Female |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 9 Years |
| Location | 650 Warrenville Rd Ste 100, Lisle, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073251724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 164.007272 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Doherty Nutrition Llc | 0941610273 | 16 |
| Provider Name | Doherty Nutrition Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1326502832 PECOS PAC ID: 0941610273 Enrollment ID: O20240321001684 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Kelly Wynne Minarick, RD, RDN, LDN 17060 Dallas Pkwy Ste 112, Dallas, TX 75248-1905 Ph: (469) 372-2022 | Mrs Kelly Wynne Minarick, RD, RDN, LDN 650 Warrenville Rd Ste 100, Lisle, IL 60532-4315 Ph: (847) 318-3013 |
Jennifer Westerkamp, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 701 Warrenville Rd Ste 210, Lisle, IL 60532 Phone: 312-664-3456 Fax: 312-588-7255 | |
Ms. Melissa M Sheehy, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2052 Lundy Ln, Lisle, IL 60532 Phone: 608-359-6048 | |
Dupagedietitians Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3080 Ogden Ave, 104, Lisle, IL 60532 Phone: 630-839-9296 Fax: 630-364-1873 | |
Mrs. Deepa Deshmukh, MPH,RD,LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3080 Ogden Ave, Lisle, IL 60532 Phone: 630-839-9296 | |
Alisha A Macas, RD Dietitian Medicare: May Accept Medicare Assignments Practice Location: 650 Warrenville Rd Ste 100, Lisle, IL 60532 Phone: 847-318-3013 Fax: 833-290-5413 | |
Emma Cone, Dietitian Medicare: May Accept Medicare Assignments Practice Location: 701 Warrenville Rd Ste 210, Lisle, IL 60532 Phone: 312-664-3456 |