Healthcare Provider Details

I. General information

NPI: 1477369775
Provider Name (Legal Business Name): ANAIS BARZOWSKI RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST STE 701
CHICAGO IL
60611-2996
US

IV. Provider business mailing address

676 N SAINT CLAIR ST STE 701
CHICAGO IL
60611-2996
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-7970
  • Fax: 312-695-4433
Mailing address:
  • Phone: 312-695-7970
  • Fax: 312-695-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2022045024
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164012279
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: