Organization
CONWAY NUTRITION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER W CONWAY (OWNER/DIRECTOR)
(708) 305-4402
Entity
Organization
Contact information
Practice address
5328 FAWN CT, OAK FOREST, IL 60452-2200
(708) 305-4402
(708) 535-2268
Mailing address
5328 FAWN CT, OAK FOREST, IL 60452-2200
(708) 305-4402
(708) 535-2268
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.001485
IL
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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