Provider Demographics
NPI:1164205357
Name:DIPIAZZA, BRITTANY SHAW (MS, RDN)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:SHAW
Last Name:DIPIAZZA
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 W BYRON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2819
Mailing Address - Country:US
Mailing Address - Phone:407-756-0475
Mailing Address - Fax:
Practice Address - Street 1:1336 W BYRON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2819
Practice Address - Country:US
Practice Address - Phone:407-756-0475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL86153896133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered