Provider Demographics
NPI:1346956687
Name:DEMI MAROPOULOS NUTRITION COUNSELING, LLC
Entity Type:Organization
Organization Name:DEMI MAROPOULOS NUTRITION COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAROPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN
Authorized Official - Phone:312-772-4595
Mailing Address - Street 1:4616 N DRAKE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-5814
Mailing Address - Country:US
Mailing Address - Phone:127-724-5953
Mailing Address - Fax:
Practice Address - Street 1:4616 N DRAKE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5814
Practice Address - Country:US
Practice Address - Phone:312-772-4595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty