Provider Demographics
NPI:1609523281
Name:FLAHAUT, ZAYNA M (RD)
Entity Type:Individual
Prefix:MS
First Name:ZAYNA
Middle Name:M
Last Name:FLAHAUT
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 1:1809 SPRING CT
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60081-8644
Mailing Address - Country:US
Mailing Address - Phone:217-781-2127
Mailing Address - Fax:
Practice Address - Street 1:1809 SPRING CT
Practice Address - Street 2:
Practice Address - City:SPRING GROVE
Practice Address - State:IL
Practice Address - Zip Code:60081-8644
Practice Address - Country:US
Practice Address - Phone:217-781-2127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL86117706133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty