Provider Demographics
NPI:1184411787
Name:ZHANG, CAROL JIN (RDN, LDN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:JIN
Last Name:ZHANG
Suffix:
Gender:
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 W LAWRENCE AVE UNIT 812
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-0533
Mailing Address - Country:US
Mailing Address - Phone:248-974-1148
Mailing Address - Fax:
Practice Address - Street 1:1139 W LAWRENCE AVE UNIT 812
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-0533
Practice Address - Country:US
Practice Address - Phone:248-974-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered