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General NPI Number Information
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NPI Number | 1013385665
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Entity Type | Individual
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Provider Name | ROBERT CHELNICK PHD
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Gender | Male
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 1601 SHERMAN AVE STE 300
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City | EVANSTON
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State | IL
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Zip | 60201-5012
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Country | US
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Telephone | 773-842-9820
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Fax | 262-554-7475
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Provider Business Mailing Address
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Address Line | 1601 SHERMAN AVE STE 300
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City | EVANSTON
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State | IL
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Zip | 60201-5012
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Country | US
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Telephone | 773-842-9820
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Fax | 262-554-7475
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 164004081
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License Number State | IL
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