Healthcare Provider Details

I. General information

NPI: 1447478748
Provider Name (Legal Business Name): ZWART NUTRITION CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 BELLE DR
NORTHLAKE IL
60164-2205
US

IV. Provider business mailing address

27 BELLE DR
NORTHLAKE IL
60164-2205
US

V. Phone/Fax

Practice location:
  • Phone: 708-562-7935
  • Fax: 708-562-7935
Mailing address:
  • Phone: 708-562-7935
  • Fax: 708-562-7935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number09920813
License Number StateIL

VIII. Authorized Official

Name: CINDY LU ZWART
Title or Position: OWNER
Credential: MNT
Phone: 708-562-7935