Provider Demographics
NPI:1225458474
Name:ROCHNOWSKI, DONNA LYNN (RD, LDN, CDE)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:ROCHNOWSKI
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 MIDTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-1275
Mailing Address - Country:US
Mailing Address - Phone:815-223-5219
Mailing Address - Fax:
Practice Address - Street 1:1651 MIDTOWN RD
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-1275
Practice Address - Country:US
Practice Address - Phone:815-223-5219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.002440133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered