Provider Demographics
NPI:1316581929
Name:SSHE RFMF INC
Entity Type:Organization
Organization Name:SSHE RFMF INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:FICEK
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:815-770-2060
Mailing Address - Street 1:611 E STEVENSON RD
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:IL
Mailing Address - Zip Code:61350-9104
Mailing Address - Country:US
Mailing Address - Phone:815-770-2060
Mailing Address - Fax:
Practice Address - Street 1:611 E STEVENSON RD
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-9104
Practice Address - Country:US
Practice Address - Phone:815-770-2060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals