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General NPI Number Information
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NPI Number | 1245819010
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Entity Type | Individual
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Provider Name | AMY N STEVENS RDN, LRD
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Gender | Female
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 1200 S YORK ST STE 1240
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City | ELMHURST
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State | IL
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Zip | 60126-5627
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Country | US
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Telephone | 331-221-6140
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Fax | 331-221-3838
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE STE 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone | 847-982-6715
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 164.008112
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 164.008112
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License Number State | IL
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