Provider Demographics
NPI:1861850646
Name:SAUBERT, DANIELLE LYNN (RDN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LYNN
Last Name:SAUBERT
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 1:1085 HASSELL RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2659
Mailing Address - Country:US
Mailing Address - Phone:847-507-9702
Mailing Address - Fax:
Practice Address - Street 1:576 BIELENBERG DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1734
Practice Address - Country:US
Practice Address - Phone:651-645-5323
Practice Address - Fax:651-348-3355
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3663133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered