Provider Demographics
NPI:1407085509
Name:VYAS, DARSHNA D (RD,LDN)
Entity Type:Individual
Prefix:MRS
First Name:DARSHNA
Middle Name:D
Last Name:VYAS
Suffix:
Gender:F
Credentials:RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 PRAIRIE POINTE LN
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-2356
Mailing Address - Country:US
Mailing Address - Phone:847-340-8808
Mailing Address - Fax:847-783-0323
Practice Address - Street 1:1301 N PLUM GROVE RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4547
Practice Address - Country:US
Practice Address - Phone:847-490-0600
Practice Address - Fax:847-490-0996
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164004292133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered