Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Anick Diessongo

Individual provider Registered Dietitian · NPI 1780463059

Anick Diessongo is a Registered Dietitian in Scott Air Force Base, Illinois. Licensed in Illinois. Registered with an NPI since 2023.

Licensed in
IL
In the registry since
2023
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Practice location Address checks out

4711 Thomas Jefferson Cir Apt A
Scott Air Force Base, IL 62225-6225
Phone: (646) 288-5143
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 164009254 (IL)

Record details

NPI number1780463059
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 26, 2023
Last updated in NPPESSeptember 26, 2023
Certification dateSeptember 26, 2023
Mailing address19310 Wildcat Trl, Davidson, NC 28036-8882

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