DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: KERRY S NELSON RD

MEDICARE: KERRY S NELSON RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1164.005078OTHERILPRIVATE

General Provider Information

NPI Number : 1205599925
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRY S NELSON RD
Provider Business Mailing Address
First Line : 1707 LAKE AVE
Second Line :
City : WILMETTE
State : IL
Zip : 60091-1537
Country : US
Telephone Number : 312-330-3358
Fax Number :
Provider Business Practice Location Address
First Line : 6303 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60660-1203
Country : US
Telephone Number : 773-270-1652
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2021
Last Update Date : 10/19/2021

Similar Medicare Providers

1750017638 — ZINA MANSOOR APRN
Practice Location Address:
6303 N CLARK ST
CHICAGO, IL
60660-1203
Practice Phone: 773-433-6210
Practice Fax: 866-744-0950
1770070013 — MARY MURAD
Practice Location Address:
6303 N CLARK ST
CHICAGO, IL
60660-1203
Practice Phone: 773-270-1652
Practice Fax:
1447731047 — DAVID ISHIKAWA PT, DPT
Practice Location Address:
6303 N CLARK ST
CHICAGO, IL
60660-1203
Practice Phone: 773-270-1652
Practice Fax:
1104585306 — JAMESA PRUITT
Practice Location Address:
6303 N CLARK ST
CHICAGO, IL
60660-1203
Practice Phone: 773-293-7599
Practice Fax:
1346986189 — HANAN KHALIL
Practice Location Address:
6303 N CLARK ST
CHICAGO, IL
60660-1203
Practice Phone: 773-433-6210
Practice Fax:
1063150423 — MUSBAH ABDI HASHI NP
Practice Location Address:
6303 N CLARK ST
CHICAGO, IL
60660-1203
Practice Phone: 773-293-7599
Practice Fax:

Directions to “ KERRY S NELSON RD” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.