CORAL NUTRITION COACH, LLC
Dietitian, Registered (Nutrition, Pediatric)

Address: 5415 S Dorchester Ave Apt Bsmt, Chicago, IL 60615-5328

CORAL NUTRITION COACH, LLC (NPI# 1649865445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649865445
Entity Type Organization
Organization Name CORAL NUTRITION COACH, LLC
Practice Address 5415 S Dorchester Ave Apt Bsmt
Chicago
IL 60615-5328
Practice Telephone 7737102237
Practice Fax Number 8722443810
Mailing Address 5415 S Dorchester Ave Apt Bsmt
Chicago
IL 60615-5328
Mailing Telephone 7737102237
Mailing Fax Number 8722443810
Certification Date 2021-03-03
Enumeration Date 2021-03-03
Last Update Date 2021-03-03
Authorized Official Telephone 7737102237
Authorized Official Credential MS, RD, LDN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Group License Number License State Taxonomy Group
Y 133VN1004X Dietitian, Registered
Specialization: Nutrition, Pediatric
193400000X SINGLE SPECIALTY GROUP Dietary & Nutritional Service Providers

Other Provider/Organization Names

Other Name Type Code
Jessica Coral Allender dba Coral Nutrition Coach Other Name

Office Location

Street Address 5415 S DORCHESTER AVE APT BSMT
City CHICAGO
State IL
Zip Code 60615-5328

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1194207522 Cindy Louise Lys Social Worker · Clinical 1525 E 53rd Street Suite 516-4, Chicago, IL 60615 2018-09-01
1659857696 Lauren G Osterbrock Physical Therapist 1644 E 53rd St, Chicago, IL 60615 2018-07-12
1740776400 Michael J Jewell Physical Therapist 1511 E Hyde Park Blvd, Chicago, IL 60615 2018-07-06
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Taxonomy Information

Taxonomy Code 133VN1004X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered
Specialization Nutrition, Pediatric

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104417294 Jamie Ray 840 S Wood St Fl 12, Chicago, IL 60612-4325 2021-02-01
1154920122 Saja Froukh 6501 S Promontory Dr, Chicago, IL 60649-1002 2020-10-21
1255945838 Patrice H. Swiontek 225 E Chicago Ave, Chicago, IL 60611-2991 2020-09-01
1770196776 Katherine Jade Arduini · Katie Jade Arduini 225 E Chicago Ave, Chicago, IL 60611-2991 2020-08-28
1740893072 Jennifer Bathgate 225 E Chicago Ave, Chicago, IL 60611-2991 2020-08-26
1487279014 Evolve Yoga & Fitness LLC 7252 W Foster Ave, Chicago, IL 60656-3612 2020-06-09
1346890688 Alexis Virlee 1700 W Van Buren St Ste 425, Chicago, IL 60612-5500 2019-09-18
1548632136 Stacie Renee Schaller · Stacie Renee Schutz 225 E Chicago Ave, Chicago, IL 60611-2991 2015-10-22
1720490709 Georgia Marinis Diakakis 849 N Franklin St, Apt 1009, Chicago, IL 60610-8793 2014-05-27
1710314927 Pamela Lynn Patt 2211 N Oak Park Ave, Chicago, IL 60707-3351 2013-10-02
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Competitor

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City CHICAGO
Zip Code 60615

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.