Provider Demographics
NPI:1235442542
Name:CUTLER, JENNIFER L (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:CUTLER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:BEYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LDN
Mailing Address - Street 1:114 BLAZING STAR
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-7467
Mailing Address - Country:US
Mailing Address - Phone:217-251-4150
Mailing Address - Fax:
Practice Address - Street 1:114 BLAZING STAR
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-7467
Practice Address - Country:US
Practice Address - Phone:217-251-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164005292133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered