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General NPI Number Information
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NPI Number | 1306365937
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Entity Type | Individual
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Provider Name | JENNIFER JEANNE SHERMAN RDN
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Gender | Female
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Dates
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Enumeration Date | 09/14/2017
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Last Update Date | 09/14/2017
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Provider Practice Location Address
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Address Line | 1048 LAKE ST STE 300
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City | OAK PARK
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State | IL
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Zip | 60301-1072
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Country | US
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Telephone | 708-383-0258
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Fax |
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Provider Business Mailing Address
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Address Line | 6253 N SHERIDAN RD APT 25
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City | CHICAGO
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State | IL
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Zip | 60660-5728
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Country | US
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Telephone | 773-573-4839
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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 | 164.007185
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License Number State | IL
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