Provider Demographics
NPI:1003437625
Name:BELTRAN, JANET (MBA, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:MBA, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 S IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-3821
Mailing Address - Country:US
Mailing Address - Phone:331-250-0312
Mailing Address - Fax:
Practice Address - Street 1:228 S IOWA AVE
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-3821
Practice Address - Country:US
Practice Address - Phone:331-250-0312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86075927133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered