Provider Demographics
NPI:1104033810
Name:ACHAR, VANITA PARIMAL (MS,RD,LDN,CDE,CNSD)
Entity Type:Individual
Prefix:MRS
First Name:VANITA
Middle Name:PARIMAL
Last Name:ACHAR
Suffix:
Gender:F
Credentials:MS,RD,LDN,CDE,CNSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 MONTEREY DR
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-2330
Mailing Address - Country:US
Mailing Address - Phone:847-549-7687
Mailing Address - Fax:
Practice Address - Street 1:800 BIESTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3311
Practice Address - Country:US
Practice Address - Phone:847-437-5500
Practice Address - Fax:847-981-3635
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.004287133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered