Individual
SHANNON OBRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
840 S WOOD ST FL 12, CHICAGO, IL 60612-4325
(312) 355-0732
(312) 355-0739
Mailing address
840 S WOOD ST FL 12, CHICAGO, IL 60612-4325
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
164006040
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164006040
LICENSED DIETITIAN NUTRITIONIST
IL
Enumeration date
02/01/2021
Last updated
05/19/2023
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