Provider Demographics
NPI:1336577634
Name:RIGGIO, VANESSA (RD, LDN)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:RIGGIO
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 1:500 W FULLERTON PKWY APT 110
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5968
Mailing Address - Country:US
Mailing Address - Phone:734-748-3859
Mailing Address - Fax:
Practice Address - Street 1:88 W SCHILLER ST APT 1601
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-2041
Practice Address - Country:US
Practice Address - Phone:312-878-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164005992133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered