Provider Demographics
NPI:1962223065
Name:ZECHMAN, KATHLEEN ANTOINETTE (RD)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ANTOINETTE
Last Name:ZECHMAN
Suffix:
Gender:U
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-7170
Mailing Address - Country:US
Mailing Address - Phone:570-948-1259
Mailing Address - Fax:
Practice Address - Street 1:701 WARRENVILLE RD STE 210
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1376
Practice Address - Country:US
Practice Address - Phone:312-664-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86102985133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered