Healthcare Provider Details

I. General information

NPI: 1538070834
Provider Name (Legal Business Name): NUTRITION FITZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19301 BRUSHWOOD LN
TINLEY PARK IL
60487-7037
US

IV. Provider business mailing address

19301 BRUSHWOOD LN
TINLEY PARK IL
60487-7037
US

V. Phone/Fax

Practice location:
  • Phone: 773-540-2768
  • Fax:
Mailing address:
  • Phone: 773-540-2768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: CHERYL FITZGERALD
Title or Position: REGISTERED DIETITIAN, OWNER
Credential: RDN, LDN
Phone: 773-540-2768