Provider Demographics
NPI:1700461035
Name:KRAUSE, EMILY MARIE (MS, RDN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 REGENCY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2369
Mailing Address - Country:US
Mailing Address - Phone:847-894-1898
Mailing Address - Fax:
Practice Address - Street 1:604 REGENCY DR
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2369
Practice Address - Country:US
Practice Address - Phone:847-894-1898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered