Provider Demographics
NPI:1588934863
Name:NELINSON, JANNA (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:JANNA
Middle Name:
Last Name:NELINSON
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 N GREENVIEW AVE
Mailing Address - Street 2:GARDEN REAR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6387
Mailing Address - Country:US
Mailing Address - Phone:972-816-5514
Mailing Address - Fax:
Practice Address - Street 1:2425 N GREENVIEW AVE
Practice Address - Street 2:GARDEN REAR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-6387
Practice Address - Country:US
Practice Address - Phone:972-816-5514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2022-06-14
Deactivation Date:2021-01-21
Deactivation Code:
Reactivation Date:2022-06-14
Provider Licenses
StateLicense IDTaxonomies
IL1018811133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered