Provider Demographics
NPI:1174317135
Name:PANGANIBAN, ZUL FRANCHESCA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ZUL FRANCHESCA
Middle Name:
Last Name:PANGANIBAN
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 1:460 SANDLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLA
Mailing Address - State:IL
Mailing Address - Zip Code:60046-9067
Mailing Address - Country:US
Mailing Address - Phone:815-514-1991
Mailing Address - Fax:
Practice Address - Street 1:460 SANDLEWOOD LANE
Practice Address - Street 2:
Practice Address - City:LAKE VILLA
Practice Address - State:IL
Practice Address - Zip Code:60046
Practice Address - Country:US
Practice Address - Phone:815-514-1991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL86292378133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered