Provider Demographics
NPI:1316698780
Name:SHEIN NUTRITION, LLC
Entity type:Organization
Organization Name:SHEIN NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEIN
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:708-927-8975
Mailing Address - Street 1:1501 CROWN LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-1260
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2047 N CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4119
Practice Address - Country:US
Practice Address - Phone:708-927-8975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty