Individual
JESSICA DIANN MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
561 W DIVERSEY PKWY STE 219, CHICAGO, IL 60614-1682
(312) 533-1754
Mailing address
561 W DIVERSEY PKWY STE 219, CHICAGO, IL 60614-1682
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164007482
IL
Other
Enumeration date
08/29/2020
Last updated
08/29/2020
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