Provider Demographics
NPI:1659094787
Name:SEVERYNS, FRANCESCA ANNA (RDN)
Entity Type:Individual
Prefix:
First Name:FRANCESCA
Middle Name:ANNA
Last Name:SEVERYNS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WATER TOWER PLACE 845 N MICHIGAN AVE
Mailing Address - Street 2:PROFESSIONAL SUITES, STE 973W
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:720 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5806
Practice Address - Country:US
Practice Address - Phone:630-730-8456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.008815133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL164.008815OtherLICENSED DIETITIAN NUTRITIONIST