Doctor Name: | MICHAEL FORNARIS |
NPI Number: | 1154705499 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RD |
License Number: | 86038995 |
Business Practice Address: | 5000 S 5th Ave Hines, IL - 601413030 |
Business Phone Number: | 7082028387 |
Business Fax Number: | |
Mailing Address: | 17308 Brook Hill Dr, ORLAND PARK |
State: | IL |
Postal Code: | 604677508 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/16/2015 |
NPI Last Update Date: | 07/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 86038995 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |