Provider Demographics
NPI:1962886846
Name:STEWART, MEGHAN E (RD)
Entity type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:E
Last Name:STEWART
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4445 W IRVING PARK RD STE 320
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2808
Mailing Address - Country:US
Mailing Address - Phone:312-695-7970
Mailing Address - Fax:312-921-0400
Practice Address - Street 1:4445 W IRVING PARK RD STE 320
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2808
Practice Address - Country:US
Practice Address - Phone:312-695-7970
Practice Address - Fax:312-921-0400
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164004568133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered