IndividualActive
Mary Miller
NPI 1629169388 · Metabolic Nutrition Registered Dietitian · Grayslake, IL
Provider details
- NPI number
- 1629169388
- Entity type
- Individual
- Primary specialty
- Metabolic Nutrition Registered DietitianDietary & Nutritional Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 164001864 (IL)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Practice location
1475 E Belvidere Rd
Pavilion C Ste 385
Grayslake, IL 60030-2012
Phone: (847) 535-7647
Fax: (847) 535-7260
Approximate (ZIP-level) locationGet directions
Mailing address
680 N Lake Shore Dr
Chicago, IL 60611-4546
Registry dates
- Enumerated
- 2006-09-27
- Last updated
- 2017-03-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.