Healthcare Provider Details

I. General information

NPI: 1447999677
Provider Name (Legal Business Name): APERTURE NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2022
Last Update Date: 06/04/2022
Certification Date: 06/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 MAPLE AVE
NORTH AURORA IL
60542-1119
US

IV. Provider business mailing address

108 MAPLE AVE
NORTH AURORA IL
60542-1119
US

V. Phone/Fax

Practice location:
  • Phone: 815-545-3713
  • Fax:
Mailing address:
  • Phone: 815-545-3713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES CAIN
Title or Position: DIETITIAN / OWNER
Credential: RD, CSSD, CSOWM, LDN
Phone: 815-545-3713