MEDICARE: CONNECTED NUTRITION COACHING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1457294050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTED NUTRITION COACHING PLLC

Provider Business Mailing Address
First Line	:	912 W DAKIN ST APT 206
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-5021
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	912 W DAKIN ST APT 206
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-5021
Country	:	US
Telephone Number	:	847-975-8943
Fax Number	:

Authorized Official
Title or Position	:	DIETITIAN
Name	:	OLA CZYZEWSKI
Credential	:	RD
Telephone Number	:	847-975-8943

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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