Provider Demographics
NPI:1972777233
Name:DUPAGE DIETITIANS
Entity Type:Organization
Organization Name:DUPAGE DIETITIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:630-839-9296
Mailing Address - Street 1:3080 OGDEN AVE
Mailing Address - Street 2:#104
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1691
Mailing Address - Country:US
Mailing Address - Phone:630-839-9296
Mailing Address - Fax:630-364-1873
Practice Address - Street 1:3080 OGDEN AVE
Practice Address - Street 2:#104
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1691
Practice Address - Country:US
Practice Address - Phone:630-839-9296
Practice Address - Fax:630-364-1873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty