OrganizationActive
A New Leaf Natural Medicine LLC
NPI 1104306240 · Registered Dietitian · Evanston, IL
Provider details
- NPI number
- 1104306240
- Entity type
- Organization
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Authorized official
- Bonnie Brock, Sole Member
- License
- 1640006979 (IL)
Mailing address
1420 W Hutchinson St Apt 3n
Chicago, IL 60613-1343
Registry dates
- Enumerated
- 2018-08-17
- Last updated
- 2020-10-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.