=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639027477
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHARIS NUTRITION COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2026
-----------------------------------------------------
Last Update Date | 03/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16119 CARLOW CIR
-----------------------------------------------------
City | MANHATTAN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60442-6107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-342-8895
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16119 CARLOW CIR
-----------------------------------------------------
City | MANHATTAN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60442-6107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-342-8895
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REGISTERED DIETITIAN
-----------------------------------------------------
Name | MRS. DAWN WHITE
-----------------------------------------------------
Credential | MS, RDN, CEDS
-----------------------------------------------------
Telephone | 815-342-8895
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------