Provider Demographics
NPI:1770101248
Name:ENCOURAGED TO NOURISH LLC
Entity type:Organization
Organization Name:ENCOURAGED TO NOURISH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN, CSSD
Authorized Official - Phone:312-401-5111
Mailing Address - Street 1:240 RED OAK RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1319
Mailing Address - Country:US
Mailing Address - Phone:312-401-5111
Mailing Address - Fax:
Practice Address - Street 1:240 RED OAK RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1319
Practice Address - Country:US
Practice Address - Phone:312-401-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports DieteticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
954008OtherREGISTERED DIETITIAN NUTRITIONIST (CDR)
IL164.004614OtherLICENSED DIETITIAN NUTRITIONIST