MEDICARE: JANET ARENAS LDN

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	164004356	IL
2	133N00000X	Nutritionist	164004356	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	164004356	OTHER	IL	PROFESSIONAL LICENSE

General Provider Information

NPI Number	:	1871709881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET ARENAS LDN

Provider Business Mailing Address
First Line	:	230 E. OHIO ST
Second Line	:	SUITE 410, 1461
City	:	CHICAGO
State	:	IL
Zip	:	60611
Country	:	US
Telephone Number	:	708-736-0966
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 E. OHIO ST
Second Line	:	SUITE 410, 1461
City	:	CHICAGO
State	:	IL
Zip	:	60611-5288
Country	:	US
Telephone Number	:	708-736-0966
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	03/12/2024

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