Provider Demographics
NPI:1619568284
Name:DINK, ADRIENNE MICHELLE (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MICHELLE
Last Name:DINK
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534 N CLAREMONT AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-1781
Mailing Address - Country:US
Mailing Address - Phone:410-507-6257
Mailing Address - Fax:
Practice Address - Street 1:2801 FINLEY RD STE 220
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1039
Practice Address - Country:US
Practice Address - Phone:630-261-9393
Practice Address - Fax:630-261-9335
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164007683133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered