Provider Demographics
NPI:1912776469
Name:OLZEWSKI, KATHLEEN MARIE (RD/RDN)
Entity Type:Individual
Prefix:MISS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:OLZEWSKI
Suffix:
Gender:F
Credentials:RD/RDN
Other - Prefix:MISS
Other - First Name:KATIE
Other - Middle Name:MARIE
Other - Last Name:OLZEWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD/RDN
Mailing Address - Street 1:1504 PORTIA RD
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-3545
Mailing Address - Country:US
Mailing Address - Phone:224-277-9168
Mailing Address - Fax:
Practice Address - Street 1:1504 PORTIA RD
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-3545
Practice Address - Country:US
Practice Address - Phone:224-277-9168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered