Provider Demographics
NPI:1750173092
Name:VLAHOS, PATRICE (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:
Last Name:VLAHOS
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:
Other - Last Name:GERACI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LDN
Mailing Address - Street 1:1101 S TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-2230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1101 S TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-2230
Practice Address - Country:US
Practice Address - Phone:630-862-8565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164007065133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered