Provider Demographics
NPI:1053846618
Name:BERLAND, LINDSAY (RD, LDN)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:BERLAND
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:WEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:440 N MCCLURG CT APT 114
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4352
Mailing Address - Country:US
Mailing Address - Phone:224-522-0585
Mailing Address - Fax:
Practice Address - Street 1:710 N FAIRBANKS CT STE 7-121
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3013
Practice Address - Country:US
Practice Address - Phone:312-926-7437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164004681133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered