NPI 1184200818 · live from the CMS NPI Registry
Miranda Lee Andres, RDN
Dietitian, Registered in Chicago, IL. National Provider Identifier 1184200818, active.
NPI record
| NPI | 1184200818 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 2551 N Clark St Ste 400, Chicago, IL 60614 |
| Practice phone | 312-533-1754 |
| Mailing address | 2065 N Hoyne Ave Apt 3m, Chicago, IL 60647 |
| Enumerated | March 23, 2021 |
| Last updated | March 23, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 164008324 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.