Provider Demographics
NPI:1740706266
Name:VAIL, JAMES D IV (DIETITIAN)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:VAIL
Suffix:IV
Gender:M
Credentials:DIETITIAN
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Mailing Address - Street 1:1001 GREEN BAY RD
Mailing Address - Street 2:# 195
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1721
Mailing Address - Country:US
Mailing Address - Phone:847-784-8812
Mailing Address - Fax:
Practice Address - Street 1:1001 GREEN BAY RD
Practice Address - Street 2:# 195
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-6009
Practice Address - Country:US
Practice Address - Phone:847-784-8812
Practice Address - Fax:847-784-8812
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2017-08-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist