Kristin A. R. Gustashaw, M.S., R.D., L.D.N.
Dietitian, Registered in Chicago, IL. Individual provider (NPI-1).
NPI number1154429751
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1154429751
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kristin A. R. Gustashaw
- Credential
- M.S., R.D., L.D.N.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 20, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 164003785 | IL | Yes |
Practice location
1700 W Van Buren StSuite 425 Tob
Chicago, IL 60612-3218
Phone 312-942-3438 · Fax 312-942-5203
Mailing address
1700 W Van Buren StSuite 425 Tob
Chicago, IL 60612-3218
Phone 312-942-3438 · Fax 312-942-5203
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