Jessica Boudreau
NPI 1023780673ActiveIndividual· Dietitian, Registered· Bourbonnais, IL
Dietitian, Registered in Bourbonnais, Illinois, licensed in IL, with an NPI issued in October 2021. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional.
Overview
| NPI | 1023780673 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Oct 1, 2021 |
| Last updated in NPPES | Oct 1, 2021 |
| Certified by provider | Oct 1, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 164.007714 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (IL) |
|---|
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