Provider Demographics
NPI:1407451818
Name:VELDHUIZEN, STEFANY (RD)
Entity Type:Individual
Prefix:
First Name:STEFANY
Middle Name:
Last Name:VELDHUIZEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WINFIELD RD STE 520
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1379
Mailing Address - Country:US
Mailing Address - Phone:630-938-8266
Mailing Address - Fax:630-933-7329
Practice Address - Street 1:25 N WINFIELD RD STE 520
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1379
Practice Address - Country:US
Practice Address - Phone:630-938-8266
Practice Address - Fax:630-933-7329
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164008878133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered