Provider Demographics
NPI:1003532714
Name:WESTERKAMP, JENNIFER (RD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WESTERKAMP
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 S STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2763
Mailing Address - Country:US
Mailing Address - Phone:630-346-4576
Mailing Address - Fax:
Practice Address - Street 1:701 WARRENVILLE RD STE 210
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1376
Practice Address - Country:US
Practice Address - Phone:312-664-3456
Practice Address - Fax:312-588-7255
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164005185133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered