Provider Demographics
NPI:1710258264
Name:NUTRITIONAL CONSULTANTS, INC.
Entity Type:Organization
Organization Name:NUTRITIONAL CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VANITA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:630-674-7539
Mailing Address - Street 1:3908 N CASS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3908 N CASS AVENUE
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2214
Practice Address - Country:US
Practice Address - Phone:630-674-7539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-14
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164000665133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1013956069OtherMEDICARE NPI