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General NPI Number Information
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NPI Number | 1033596424
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Entity Type | Individual
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Provider Name | COURTNEY KATHLEEN SHORTRIDGE MS, RD
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Gender | Female
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 1625 FREEMAN RD
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60192-1624
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Country | US
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Telephone | 708-743-9743
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Fax |
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Provider Business Mailing Address
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Address Line | 1625 FREEMAN RD
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60192-1624
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Country | US
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Telephone | 708-743-9743
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Fax |
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86037692
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License Number State | IL
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