Provider Demographics
NPI:1891155834
Name:HOPPENSTEADT, JODI M (MS, RDN)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:M
Last Name:HOPPENSTEADT
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 ALMOND CT
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1340
Mailing Address - Country:US
Mailing Address - Phone:630-258-0873
Mailing Address - Fax:
Practice Address - Street 1:1555 ALMOND CT
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1340
Practice Address - Country:US
Practice Address - Phone:630-258-0873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered