| Avellino Group, Ltd. | |
|
1460 N Halsted St Ste 202, Chicago, IL 60642-2612 | |
| (312) 533-7500 | |
| (312) 778-5993 |
| Full Name | Avellino Group, Ltd. |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered - Nutrition, Metabolic |
| Location | 1460 N Halsted St Ste 202, Chicago, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215282868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133VN1006X | Dietitian, Registered - Nutrition, Metabolic | 164003355 (Illinois) | Primary |
| Provider Name | Nagendra S Koneru |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1508989260 PECOS PAC ID: 2769578830 Enrollment ID: I20090904000245 |
| Provider Name | Carla Heiser |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1578741013 PECOS PAC ID: 9133373327 Enrollment ID: I20130218000456 |
| Mailing Address | Practice Location Address |
|---|---|
| Avellino Group, Ltd. 6400 Industrial Loop, Greendale, WI 53129-2452 Ph: (414) 423-4100 | Avellino Group, Ltd. 1460 N Halsted St Ste 202, Chicago, IL 60642-2612 Ph: (312) 533-7500 |
Mrs. Marissa Lynn Varner, R.D, M.S. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 7435 W Talcott Ave, Health Management Office, Chicago, IL 60631 Phone: 773-594-7448 Fax: 773-594-8454 | |
Mrs. Mireya E Renteria, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2355 S Western Ave, Chicago, IL 60608 Phone: 773-650-1220 Fax: 773-650-1218 | |
Vanessa Alicea Matos, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2003 W Fulton St, Suite 105, Chicago, IL 60612 Phone: 312-850-3438 Fax: 312-638-9872 | |
Mrs. Renee Ann Clerkin, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2300 W Wabansia Ave, Unit 214, Chicago, IL 60647 Phone: 317-442-5134 | |
Elizabeth Murphy, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 1015 W Lawrence Ave, Chicago, IL 60640 Phone: 773-751-1731 | |
Alice Touma, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1525 W Homer St Ste 101, Chicago, IL 60642 Phone: 888-785-7370 | |
Miss Jun Phan, RDN,LDN Dietitian Medicare: Medicare Enrolled Practice Location: 850 W Irving Park Rd, Chicago, IL 60613 Phone: 773-975-6802 |