IndividualActive
Shirley Poole, RD CSP LDN
NPI 1205960705 · Pediatric Nutrition Registered Dietitian · Rockford, IL
Provider details
- NPI number
- 1205960705
- Entity type
- Individual
- Primary specialty
- Pediatric Nutrition Registered DietitianDietary & Nutritional Service Providers
- Credential
- RD CSP LDN
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Dietary & Nutritional Service Providers
Practice location
1401 E State St
Rockford, IL 61104-2315
Phone: (815) 489-4667
Fax: (815) 964-5404
Approximate (ZIP-level) locationGet directions
Mailing address
11249 Chaney Dr
Machesney Park, IL 61115-7438
Registry dates
- Enumerated
- 2007-03-15
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.