Provider Demographics
NPI:1770906463
Name:MILLIKAN, JANET (RDN)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MILLIKAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 WREN CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1433
Mailing Address - Country:US
Mailing Address - Phone:630-980-7543
Mailing Address - Fax:
Practice Address - Street 1:231 WREN CT
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1433
Practice Address - Country:US
Practice Address - Phone:630-980-7543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.001774133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered