Provider Demographics
NPI:1316378193
Name:ZAJC, AIMEE JEANNE (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:JEANNE
Last Name:ZAJC
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 S YORK ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5115
Mailing Address - Country:US
Mailing Address - Phone:630-336-1514
Mailing Address - Fax:
Practice Address - Street 1:944 S YORK ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5115
Practice Address - Country:US
Practice Address - Phone:630-336-1514
Practice Address - Fax:630-834-0238
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.003971133V00000X, 133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal