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Individual

MS. SAMANTHA GIANAKAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD, LDN

Contact information

Practice address
520 S MAPLE AVE, OAK PARK, IL 60304-1022
(708) 660-6306
Mailing address
520 S MAPLE AVE, OAK PARK, IL 60304-1022
(708) 660-6306

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164007556
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164007556
IL
Enumeration date
07/28/2020
Last updated
07/28/2020
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