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Organization
THE FAMILY DIETITIANS
Active
Organization
THE FAMILY DIETITIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE VLAZNY STILES RD (DIETITIAN)
(773) 875-5683
Entity
Organization
Contact information
Practice address
5600 WOLF RD STE 135, WESTERN SPRINGS, IL 60558-2201
(773) 875-5683
Mailing address
5600 WOLF RD STE 135, WESTERN SPRINGS, IL 60558-2201
(773) 875-5683
(708) 274-1163
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659760536
—
IL
Enumeration date
10/26/2023
Last updated
10/27/2023
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