SUREN JENNY CHIU (NPI# 1275006074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275006074 |
| Entity Type | Individual |
| Full Name | SUREN JENNY CHIU |
| Other Name | SUREN KANCHANAVALEERAT |
| Credential | LDN |
| Practice Address |
4775 E Maryland St Decatur IL 62521-8802 |
| Practice Telephone | 2178763737 |
| Practice Fax Number | 2178763468 |
| Mailing Telephone | 2178643737 |
| Mailing Fax Number | 2178643468 |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2020-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133N00000X | Nutritionist | 164.007568 | IL | Dietary & Nutritional Service Providers |
| Y | 133V00000X | Dietitian, Registered | 164.007568 | IL | Dietary & Nutritional Service Providers |
| Street Address |
4775 E MARYLAND ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-8802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1912476599 | Jenna Nicole Stowers | Nurse Practitioner | 4775 E Maryland St, Decatur, IL 62521-8802 | 2018-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| 1275781593 | Deborah Deloney | Speech-Language Pathologist | Fairhaven Christian Home, 1790 South Fairview, Decatur, IL 62521 | 2008-08-28 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588281018 | Annie Laine Parks | Dietitian, Registered | 805 N Trinity St, Decatur, TX 76234-1146 | 2020-06-30 |
| 1336768167 | Sylvia P Poulos | Dietitian, Registered | 1989 Wilandrew Dr, Decatur, GA 30033-1917 | 2020-04-12 |
| 1811478472 | Holley Nash | Dietitian, Registered | 1201 Clairmont Rd Ste 110, Decatur, GA 30030-1258 | 2018-08-22 |
| 1124538129 | Anna Leigh Blevens | Dietitian, Registered | 115 N Mcdonough St Ste A, Decatur, GA 30030-3354 | 2017-10-04 |
| 1497293955 | Rachel Anne Mcbride | Dietitian, Registered | 81 Pennsylvania Dr, Decatur, IL 62526-2349 | 2017-02-05 |
| 1235584111 | Christi Hansen | Dietitian, Registered | 253 Forkner Dr, Decatur, GA 30030-1612 | 2016-04-28 |
| 1639537822 | Moira Faris | Dietitian, Registered | 292 W Parkwood Rd, Decatur, GA 30030-2821 | 2016-02-03 |
| 1326479262 | Lori Ann Scholle | Dietitian, Registered | 615 Ponce De Leon Pl, Decatur, GA 30030-5108 | 2013-12-03 |
| 1851695126 | Vera Green | Dietitian, Registered | 2320 N Eiffel Ct, Decatur, GA 30032-5633 | 2010-12-30 |
| 1427375286 | Kimberly Ann Donohue | Dietitian, Registered | 1874 Beltine Rd, Decatur, AL 35601 | 2010-05-03 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.