Provider Demographics
NPI:1245617240
Name:BURNS, JULIE (MS, RD, CCN)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:MS, RD, CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6688 JOLIET RD STE 193
Mailing Address - Street 2:
Mailing Address - City:COUNTRYSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-4575
Mailing Address - Country:US
Mailing Address - Phone:708-246-9774
Mailing Address - Fax:
Practice Address - Street 1:12 SALT CREEK LN STE 300
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-8611
Practice Address - Country:US
Practice Address - Phone:708-246-9774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.001960133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered