MR. CHRIS M. GELDERNICK (NPI# 1740555093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740555093 |
| Entity Type | Individual |
| Full Name | MR. CHRIS M. GELDERNICK |
| Credential | MS RD LDN |
| Practice Address |
1005 Broadway St Quincy IL 62301-2834 |
| Mailing Address |
1601 S 24th St Apt 410 Quincy IL 62301-6965 |
| Practice Telephone | 2172238400 |
| Practice Fax Number | 2172239716 |
| Mailing Telephone | 6302094390 |
| Mailing Fax Number | 2172239716 |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2012-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1006X |
Dietitian, Registered Specialization: Nutrition, Metabolic |
164005594 | IL | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD ILLINOIS | 00132061 | 01 |
| Street Address |
1005 BROADWAY ST |
| City | QUINCY |
| State | IL |
| Zip Code | 62301-2834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194729087 | Mary F Barthel | Internal Medicine | 1005 Broadway St, Quincy, IL 62301-2834 | 2005-06-08 |
| 1861093528 | Kayla Cathleen Fletcher | Pharmacist | 1005 Broadway St, Quincy, IL 62301-2834 | 2020-11-07 |
| 1124629035 | Carla Sue Smith | Clinical Nurse Specialist | 1005 Broadway St, Quincy, IL 62301-2834 | 2020-11-06 |
| 1164023636 | Whitney Brock | Nurse Practitioner | 1005 Broadway St, Quincy, IL 62301-2834 | 2020-11-02 |
| 1851918635 | Mitchell Andrew Coval | Nurse Anesthetist, Certified Registered | 1005 Broadway St, Quincy, IL 62301-2834 | 2020-06-29 |
| 1699392415 | Jaryn S Black | Nurse Practitioner | 1005 Broadway St, Quincy, IL 62301-2834 | 2020-06-27 |
| 1326677535 | Angie Rose | Nurse Practitioner | 1005 Broadway St, Quincy, IL 62301-2834 | 2020-04-08 |
| 1386274843 | Lisa Marie Orton | Nurse Practitioner | 1005 Broadway St, Quincy, IL 62301-2834 | 2020-01-23 |
| 1497393847 | Benjamin Nash | Nurse Anesthetist, Certified Registered | 1005 Broadway St, Quincy, IL 62301-2834 | 2019-12-17 |
| 1851938476 | Nichole Suzanne Stanley | Nurse Practitioner | 1005 Broadway St, Quincy, IL 62301-2834 | 2019-12-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969471 | Lutheran Child and Family Service of Illinois | Foster Care Agency | 1400 N. 30th St, Quincy, IL 62301 | 2020-07-07 |
| 1134749716 | Bethany Nicole Jumps | Pharmacist | Broadway St & N 11th St, Quincy, IL 62301 | 2020-04-23 |
| 1043844293 | S.crider Construction An Supply Corp. | Contractor | 529 Woodbridge Dr., Quincy, IL 62301 | 2020-02-26 |
| 1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
| 1043851488 | West Central Illinois Nutrition | In Home Supportive Care | 639 York St. Room 333, Quincy, IL 62301 | 2019-10-07 |
| 1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
| 1194255083 | Michael Andrew Behrens | Nurse Practitioner | Broadway and 11th Street, Quincy, IL 62301 | 2017-06-14 |
| 1770987323 | Kirsty Yvonne Reed | Counselor | 205 S. 24th Street, Chaddock, Quincy, IL 62301 | 2014-10-10 |
| 1114234499 | Dale D. Shahan Dds Ltd | Dentist | 636 Hampshire Suite 102, Quincy, IL 62301 | 2010-09-08 |
| 1730314071 | James D Kaufmann | Pharmacist | 14th & Broadway, Quincy, IL 62301 | 2009-05-15 |
| Find all providers in zip 62301 | ||||
| Taxonomy Code | 133VN1006X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Metabolic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073847539 | Luz Adriana Sancen De Brown | Dietitian, Registered | 2009 Elm St, Quincy, IL 62301-3233 | 2009-09-30 |
| 1710248448 | Ami Diane Froese | Dietitian, Registered | 1005 Broadway St, Quincy, IL 62301-2834 | 2012-05-29 |
| 1811227549 | Megan Elizabeth Moon | Dietitian, Registered | 1415 Vermont St, Quincy, IL 62301-3119 | 2009-12-31 |
| 1326270133 | Brittany Marie Winship | Dietitian, Registered | 3700 Broadway St, Quincy, IL 62305-2822 | 2009-08-12 |
| 1821236878 | Sarah Jean Rommesmo | Dietitian, Registered | 1005 Broadway St, Quincy, IL 62301-2834 | 2009-01-29 |
| 1902059256 | Lily Lam | Dietitian, Registered | 1005 Broadway St, Quincy, IL 62301-2834 | 2008-10-30 |
| 1063681906 | Blessing Hospital | Dietitian, Registered | 1005 Broadway St, Quincy, IL 62301-2834 | 2008-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228456 | The Angelo Method Tam LLC | Dietitian, Registered | 5440 N Cumberland Ave Ste 225, Chicago, IL 60656-1531 | 2019-01-02 |
| 1568893535 | Jason Caraballo | Dietitian, Registered | 1002 Monticello Dr, Aurora, IL 60506-5740 | 2013-12-02 |
| 1922238989 | Siu Mui Carman Cheng | Dietitian, Registered | 2850 S Michigan Ave, Chicago, IL 60616-5018 | 2009-07-23 |
| 1457506214 | Corporate Wellness Inc | Dietitian, Registered | 2272 W 95th St Ste 305, Naperville, IL 60564-8944 | 2008-11-20 |
| 1629227913 | Harriet Shelley Salzberg | Dietitian, Registered | 276 Chicory Ln, Buffalo Grove, IL 60089-1835 | 2008-09-11 |
| 1053456384 | Susan Kagen Podell | Dietitian, Registered | 560 N Midlothian Rd, Suite 400, Mundelein, IL 60060-1654 | 2007-02-21 |
| 1992299788 | Walsh Nutrition Group, Inc. | Dietitian, Registered | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527-0833 | 2018-06-15 |
| 1639663412 | Laura Walsh | Dietitian, Registered | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527-0833 | 2018-06-15 |
| 1477045763 | Andrea Williams | Dietitian, Registered | 800 E 55th St, Chicago, IL 60615-4906 | 2018-06-01 |
| 1114425618 | Neda Khudeira | Dietitian, Registered | 8071 S Cicero Ave, Chicago, IL 60652-2003 | 2018-01-30 |
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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.