NPI 1003104860 · live from the CMS NPI Registry
Vanessa Alicea Matos, R.D.
Dietitian, Registered in Chicago, IL. National Provider Identifier 1003104860, active.
NPI record
| NPI | 1003104860 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 2003 W Fulton St, Suite 105, Chicago, IL 60612 |
| Practice phone | 312-850-3438 |
| Enumerated | July 14, 2011 |
| Last updated | April 3, 2024 |
| Sole proprietor | No |
| Other names | Vanessa Alicea |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 164005257 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.