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NPI Code Detail

MEDICARE: MS. MEGAN CHRISTINA KOPFENSTEINER MS, RD, LDN, CNSC

MEDICARE: MS. MEGAN CHRISTINA KOPFENSTEINER MS, RD, LDN, CNSC
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
1133V00000XRegistered Dietitian164.005497IL

General Provider Information

NPI Number : 1700139284
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MEGAN CHRISTINA KOPFENSTEINER MS, RD, LDN, CNSC
Provider Business Mailing Address
First Line : 7101 W HIGGINS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1903
Country : US
Telephone Number : 317-709-3430
Fax Number :
Provider Business Practice Location Address
First Line : 7101 W HIGGINS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1903
Country : US
Telephone Number : 317-709-3430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2012
Last Update Date : 03/27/2015

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