# LISA'S NUTRITION HUB, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518720796
- **Authorized official:** MRS. LISA MARIE TESTOLIN MS, RD, LDN (OWNER/REGISTRED DIETITIAN)
- **Authorized official phone:** (630) 550-0429

## Contact information

- **Practice address:** 132 W LAKE ST, BLOOMINGDALE, IL 60108-1020
- **Practice address phone:** (630) 550-0429
- **Mailing address:** 327 ERIE CIR, BLOOMINGDALE, IL 60108-8813
- **Mailing address phone:** (630) 550-0429

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 133VN1004X | Pediatric Nutrition Registered Dietitian | — | NULL | — |
| 133VN1004X | Pediatric Nutrition Registered Dietitian | — | — | — |
| 133VN1006X | Metabolic Nutrition Registered Dietitian | — | NULL | Yes |
| 133VN1006X | Metabolic Nutrition Registered Dietitian | — | — | Yes |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | NULL | — |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | — | — |

## Other

- **Enumeration date:** 01/31/2024
- **Last updated:** 01/31/2024