Healthcare Provider Details

I. General information

NPI: 1669254777
Provider Name (Legal Business Name): MOLLY JANE DOWNEY RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 04/19/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 JACKSON AVE
RIVER FOREST IL
60305-1413
US

IV. Provider business mailing address

807 JACKSON AVE
RIVER FOREST IL
60305-1413
US

V. Phone/Fax

Practice location:
  • Phone: 708-828-5416
  • Fax:
Mailing address:
  • Phone: 708-828-5416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164007652
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: