Provider Demographics
NPI:1285026831
Name:FARR, RHONDA (RD)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:
Last Name:FARR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N COUNTY FARM RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-3977
Mailing Address - Country:US
Mailing Address - Phone:360-382-7400
Mailing Address - Fax:630-510-5412
Practice Address - Street 1:111 N COUNTY FARM RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-3977
Practice Address - Country:US
Practice Address - Phone:630-682-7400
Practice Address - Fax:630-510-5412
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.000210133V00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered