Individual
PATRICIA COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, CSSD
Contact information
Practice address
240 RED OAK RD, NORTHBROOK, IL 60062-1319
(312) 401-5111
Mailing address
240 RED OAK RD, NORTHBROOK, IL 60062-1319
(312) 612-9255
(312) 668-8589
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164004614
IL
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
954008
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164.004614
LICENSED DIETITIAN NUTRITIONIST
IL
Enumeration date
07/13/2020
Last updated
09/02/2020
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