Provider Demographics
NPI:1073640132
Name:HEMZACEK, KAREN LOUISE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LOUISE
Last Name:HEMZACEK
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 WILEY RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4380
Mailing Address - Country:US
Mailing Address - Phone:847-310-4730
Mailing Address - Fax:847-310-4735
Practice Address - Street 1:1261 WILEY RD
Practice Address - Street 2:SUITE L
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4380
Practice Address - Country:US
Practice Address - Phone:847-310-4730
Practice Address - Fax:847-310-4735
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164002456133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL202486Medicare ID - Type UnspecifiedDIETITIAN