Provider Demographics
NPI:1619558764
Name:KULIKOWSKI, ANGELICA KATHERINE (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:KATHERINE
Last Name:KULIKOWSKI
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7422 SEMINOLE DR
Mailing Address - Street 2:
Mailing Address - City:WONDER LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60097-8358
Mailing Address - Country:US
Mailing Address - Phone:847-322-3360
Mailing Address - Fax:
Practice Address - Street 1:7422 SEMINOLE DR
Practice Address - Street 2:
Practice Address - City:WONDER LAKE
Practice Address - State:IL
Practice Address - Zip Code:60097-8358
Practice Address - Country:US
Practice Address - Phone:847-322-3360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered