Provider Demographics
NPI:1629227913
Name:SALZBERG, HARRIET S (RD, LDN, CDE)
Entity Type:Individual
Prefix:MRS
First Name:HARRIET
Middle Name:S
Last Name:SALZBERG
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 WAUKEGAN RD STE 140
Mailing Address - Street 2:
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1868
Mailing Address - Country:US
Mailing Address - Phone:847-663-8540
Mailing Address - Fax:847-663-1015
Practice Address - Street 1:2151 WAUKEGAN RD STE 140
Practice Address - Street 2:
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1868
Practice Address - Country:US
Practice Address - Phone:847-663-8540
Practice Address - Fax:847-663-1015
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164001784133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic