Provider Demographics
NPI:1720419393
Name:MAY, JESSICA ANN (MBA, RD, LDN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:MAY
Suffix:
Gender:F
Credentials:MBA, RD, LDN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ANN
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9977 WOODS DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1057
Mailing Address - Country:US
Mailing Address - Phone:847-663-8540
Mailing Address - Fax:847-663-1015
Practice Address - Street 1:9977 WOODS DR STE 300
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077
Practice Address - Country:US
Practice Address - Phone:847-663-8540
Practice Address - Fax:847-663-1015
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.006090133NN1002X, 133VN1006X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic