Ignite Nutrition
Dietitian, Registered in Chicago, IL. Organization (NPI-2).
NPI number1801502000
StatusActive
Last updated in NPPESJan 30, 2023
Details
- NPI
- 1801502000
- Entity type
- Organization (NPI-2)
- Legal business name
- Ignite Nutrition
- Organization subpart
- No
- Enumeration date
- Jan 30, 2023
- Certification date
- Jan 30, 2023
- Last updated
- Jan 30, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | – | Yes |
Other names
- Ignite Nutrition Counseling (Doing Business As)
Practice location
730 S Clark St Apt 312Chicago, IL 60605-1744
Phone 815-721-6145
Mailing address
730 S Clark St Apt 312Chicago, IL 60605-1744
Authorized official
Jessica Martinez
Ceo
8157216145
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