Provider Demographics
NPI:1407065147
Name:THOMSON, CHRISTINE DYAN (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DYAN
Last Name:THOMSON
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 CRESCENT PARK CIR UNIT 255
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-7503
Mailing Address - Country:US
Mailing Address - Phone:800-209-5139
Mailing Address - Fax:
Practice Address - Street 1:9750 CRESCENT PARK CIR UNIT 255
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-7503
Practice Address - Country:US
Practice Address - Phone:800-209-5139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.003638133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered