Provider Demographics
NPI:1073352597
Name:CANO, LUIS FELIPE (RD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:FELIPE
Last Name:CANO
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 RANDALL RD STE B
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4201
Mailing Address - Country:US
Mailing Address - Phone:630-315-1700
Mailing Address - Fax:630-938-8330
Practice Address - Street 1:308 RANDALL RD STE B
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4201
Practice Address - Country:US
Practice Address - Phone:630-315-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered