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Contact Information

TERI BROADNAX, LDN, CNS
20 FOREST BLVD
PARK FOREST, IL60466-1753
 Phone: 630-890-3081
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutritionist

133N00000X
Indicates primary specialty

NPI Profile & details for TERI BROADNAX · (Female)

NPI Number 1447964499
Status Active
Credentials LDN, CNS
Entity Individual
Enumeration date 01/12/2023
Last updated 01/12/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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