Provider Demographics
NPI:1477177251
Name:MENEGUS, STEVEN (RD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:MENEGUS
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 FYRE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:SHERRARD
Mailing Address - State:IL
Mailing Address - Zip Code:61281-9349
Mailing Address - Country:US
Mailing Address - Phone:925-899-8450
Mailing Address - Fax:
Practice Address - Street 1:1317 FYRE LAKE DR
Practice Address - Street 2:
Practice Address - City:SHERRARD
Practice Address - State:IL
Practice Address - Zip Code:61281-9349
Practice Address - Country:US
Practice Address - Phone:925-899-8450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86112841133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered