Provider Demographics
NPI:1073254132
Name:SCAWINSKI, STEPHANIE ANN
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ANN
Last Name:SCAWINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:ANN
Other - Last Name:SCHMELING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LD, CLS
Mailing Address - Street 1:500 ARBOR AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-6311
Mailing Address - Country:US
Mailing Address - Phone:847-946-3864
Mailing Address - Fax:
Practice Address - Street 1:500 ARBOR AVE
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-6311
Practice Address - Country:US
Practice Address - Phone:847-946-3864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164008399133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered