Provider Demographics
NPI:1588108005
Name:QUAID, VINCENZA (RD, LDN)
Entity type:Individual
Prefix:
First Name:VINCENZA
Middle Name:
Last Name:QUAID
Suffix:
Gender:F
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 1:223 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-5027
Mailing Address - Country:US
Mailing Address - Phone:847-323-5047
Mailing Address - Fax:
Practice Address - Street 1:223 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-5027
Practice Address - Country:US
Practice Address - Phone:847-323-5047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164004073133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered