MEDICARE: CLAYTON JOSEPH MEYER RDN

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
1	133V00000X	Registered Dietitian	164007803	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811548183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAYTON JOSEPH MEYER RDN

Provider Business Mailing Address
First Line	:	1943 S MAY ST # 1F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-3359
Country	:	US
Telephone Number	:	312-549-8866
Fax Number	:

Provider Business Practice Location Address
First Line	:	1943 S MAY ST # 1F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-3359
Country	:	US
Telephone Number	:	312-549-8866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2019
Last Update Date	:	04/02/2020

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