Emily Simo, MS RDN LDN

Individual provider Active NPI Registered Dietitian · Chicago, IL

NPI 1043976038 · NPPES record last updated Nov 13, 2021

Key facts

NPI
1043976038
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
164.008118 (IL)
Practice address
3921 N Lincoln Ave
Chicago, IL 60613-2417
Phone
(630) 352-8813
NPI assigned
Nov 13, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
164.008118ILMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164.008118 IL Yes

Addresses

Primary practice location

3921 N Lincoln Ave
Chicago, IL 60613-2417

Mailing address

629 W Crockett Ave
Elmhurst, IL 60126-1855
Phone (630) 352-8813

Other providers in Chicago, IL

All providers in Chicago, IL · Registered Dietitian in Illinois

Sources for this page

Verify at the official NPI Registry.