PHC OF BUFFALO GROVE NUTRITION NPI 1902107386

NPI Information

  • NPI: 1902107386
  • Provider Name: PHC OF BUFFALO GROVE NUTRITION
  • Classification: Dietitian, Registered - 133V00000X
  • Entity Type: Organization
  • Doing Business As: PORTRAIT HEALTH CENTERS
  • Address: 175 E HAWTHORN PKWY
    SUITE 235
    VERNON HILLS, IL
    ZIP 60061
  • Phone: (847) 868-3435

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NPI Details

PHC OF BUFFALO GROVE NUTRITION is a dietitian registered in Vernon Hills, IL. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. PHC OF BUFFALO GROVE NUTRITION NPI is 1902107386. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Portrait Health Centers.

The provider's business location address is:

175 E HAWTHORN PKWY
SUITE 235
VERNON HILLS, IL
ZIP 60061-463
Phone: (847) 868-3435
Fax: (847) 859-5855

The provider's authorized official is Jeremy Warner .
The authorized official title is Practice Manager and has the following contact phone number (847) 868-3435.

The enumeration date for this NPI number is 11/16/2010 and was last updated on 9/12/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133V00000XDietitian, Registered164005333ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1IL8503MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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