Provider Demographics
NPI:1407648900
Name:MERIWETHER, SYMONE (ND, CNS, LDN)
Entity type:Individual
Prefix:
First Name:SYMONE
Middle Name:
Last Name:MERIWETHER
Suffix:
Gender:F
Credentials:ND, CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 KINNICK DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-5537
Mailing Address - Country:US
Mailing Address - Phone:765-210-6388
Mailing Address - Fax:
Practice Address - Street 1:205 N MICHIGAN AVE STE 810
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5902
Practice Address - Country:US
Practice Address - Phone:872-240-4807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164012186133NN1002X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education