=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801295985
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET MEZNARICK RDN, LDN, CDE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2014
-----------------------------------------------------
Last Update Date | 05/25/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2701 PATRIOT BLVD
-----------------------------------------------------
City | GLENVIEW
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60026-8039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-998-9483
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 E SCHAUMBURG RD STE 101
-----------------------------------------------------
City | SCHAUMBURG
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60194-3548
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-252-6090
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 164.006169
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------