Individual
JUDITH ELIZABETH KOLISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN, CDE
Contact information
Practice address
5225 OLD ORCHARD RD. SUITE 6, SKOKIE, IL 60077-1057
(847) 529-6796
Mailing address
2638 W LAKE AVE, GLENVIEW, IL 60026-8038
(847) 529-6796
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164-002845
IL STATE LIC
IL
Enumeration date
01/03/2007
Last updated
12/20/2016
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