Provider Demographics
NPI:1427542141
Name:LAMONT, THERESA (RD, LDN)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:LAMONT
Suffix:
Gender:
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 W SHERWIN AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-6252
Mailing Address - Country:US
Mailing Address - Phone:708-628-8506
Mailing Address - Fax:
Practice Address - Street 1:1549 W SHERWIN AVE APT 303
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-6252
Practice Address - Country:US
Practice Address - Phone:708-628-8506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-16
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.007363133V00000X
IL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered