Provider Demographics
NPI:1942801709
Name:STONE, AMELIA CLAIRE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:CLAIRE
Last Name:STONE
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 W WRIGHTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1755
Mailing Address - Country:US
Mailing Address - Phone:314-745-8135
Mailing Address - Fax:314-328-8095
Practice Address - Street 1:443 W WRIGHTWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1755
Practice Address - Country:US
Practice Address - Phone:314-745-8135
Practice Address - Fax:314-328-8095
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X, 133NN1002X, 133VN1005X, 133VN1006X, 133VN1101X, 133VN1201X
IL164.008449133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
No133VN1101XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Gerontological
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management