SOUTHERN ILLINOIS NUTRITION SPECIALTIES (NPI# 1487700696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487700696 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS NUTRITION SPECIALTIES |
| Practice Address |
1350 Cedar Ct Carbondale IL 62901-5336 |
| Mailing Address |
Po Box 3301 Carbondale IL 62902-3301 |
| Practice Telephone | 6189427300 |
| Mailing Telephone | 6189427300 |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LORI TRENTACOSTI (OWNER) |
| Authorized Official Telephone | 6189427300 |
| Authorized Official Credential | R.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | IL | Dietary & Nutritional Service Providers |
| Street Address |
1350 CEDAR CT |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-5336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780682732 | Randy Gene Cowart | Internal Medicine | 1350 Cedar Ct, Carbondale, IL 62901-5336 | 2005-07-13 |
| 1982109419 | Jacqueline B Biggs | Internal Medicine | 1350 Cedar Ct, Carbondale, IL 62901-5336 | 2018-03-27 |
| 1053833343 | Stuart Kent Lankford | Internal Medicine | 1350 Cedar Ct, Carbondale, IL 62901-5336 | 2017-07-09 |
| 1447288501 | Yuan Chen | Internal Medicine | 1350 Cedar Ct, Carbondale, IL 62901-5336 | 2006-06-29 |
| 1679511281 | Mary Rosenhauer | Physician Assistant | 1350 Cedar Ct, Carbondale, IL 62901-5336 | 2006-06-04 |
| 1992763312 | Muhammad Kamran | Internal Medicine | 1350 Cedar Ct, Carbondale, IL 62901-5336 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477034692 | Kylee Schuler Van Horn | Dietitian, Registered | 380 Oak Run Rd, Carbondale, CO 81623-2811 | 2018-08-25 |
| 1124498886 | Rebecca Leigh Colwell | Dietitian, Registered | 900 S Elizabeth St Apt 3, Carbondale, IL 62901-2572 | 2015-10-06 |
| 1336492107 | Red Runner Coaching LLC | Dietitian, Registered | 879 Main St, Carbondale, CO 81623-1949 | 2012-10-18 |
| 1922141001 | Jill Fabri | Dietitian, Registered | 100 Lincoln Ave, Carbondale, PA 18407-2116 | 2007-02-15 |
| 1982747077 | Nicole Coppola | Dietitian, Registered | 100 Lincoln Ave, Carbondale, PA 18407-2116 | 2007-02-15 |
| 1508913427 | Lori Trentacosti | Dietitian, Registered | 2601 W Main St, Carbondale, IL 62901-1031 | 2007-01-04 |
| 1942395751 | Stephanie Victoria Wood | Dietitian, Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366726 | Frankie O'brien | Dietitian, Registered | 2551 N Clark St Ste 400, Chicago, IL 60614-7725 | 2020-11-04 |
| 1841891207 | Elizabeth Kristin Julius | Dietitian, Registered | 833 W Buena Ave Apt 1901, Chicago, IL 60613-6634 | 2020-11-03 |
| 1417556747 | Jamie Anne Mayhew | Dietitian, Registered | 2917 W 99th Pl, Evergreen Park, IL 60805-2641 | 2020-10-19 |
| 1033716345 | Efthemia Greco | Dietitian, Registered | 9654 Kelley Ln, Huntley, IL 60142-0058 | 2020-10-08 |
| 1679170203 | Lotus Therapy Group Inc | Dietitian, Registered | 112 Kansas St, Frankfort, IL 60423-1447 | 2020-10-06 |
| 1447857065 | Tran Huynh | Dietitian, Registered | 6126 N Rockwell St Apt 3, Chicago, IL 60659-2859 | 2020-10-06 |
| 1033716113 | Ulani Villanueva | Dietitian, Registered | 470 Pfingsten Road, Northbrook, IL 60062-2506 | 2020-10-02 |
| 1780281873 | Alyssa Marie Post | Dietitian, Registered | 3512 Rollingridge Rd, Naperville, IL 60564-8298 | 2020-10-02 |
| 1285231324 | Megan Rhodes | Dietitian, Registered | 539 Willowcreek Ct, Clarendon Hills, IL 60514-1693 | 2020-10-01 |
| 1508473711 | Susan Faith Madnek-oxman | Dietitian, Registered | 1051 Wade St, Highland Park, IL 60035-4153 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.