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General NPI Number Information
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NPI Number | 1407648900
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Entity Type | Individual
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Provider Name | SYMONE MERIWETHER ND, CNS, LDN
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Gender | Female
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 205 N MICHIGAN AVE STE 810
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City | CHICAGO
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State | IL
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Zip | 60601-5902
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Country | US
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Telephone | 872-240-4807
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Fax |
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Provider Business Mailing Address
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Address Line | 131 KINNICK DR
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City | GREENWOOD
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State | IN
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Zip | 46143-5537
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Country | US
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Telephone | 765-210-6388
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 164012186
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 164012186
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License Number State | IL
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