| Your Kidney Dietitian Pllc | |
| 
					4631 N Lincoln Ave, Chicago, IL 60625-2007  | |
| (224) 725-3530 | |
| (312) 646-4120 | 
| Full Name | Your Kidney Dietitian Pllc | 
|---|---|
| Type | Facility | 
| Speciality | Dietitian, Registered | 
| Location | 4631 N Lincoln Ave, 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 | 
|---|---|---|---|
| 1336894856 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary | 
| Provider Name | Caitlin Marie Kanner | 
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional | 
| Provider Identifiers | NPI Number: 1962838680 PECOS PAC ID: 4587899612 Enrollment ID: I20220307002498  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Your Kidney Dietitian Pllc 4631 N Lincoln Ave, Chicago, IL 60625-2007 Ph: (224) 725-3530  | Your Kidney Dietitian Pllc 4631 N Lincoln Ave, Chicago, IL 60625-2007 Ph: (224) 725-3530  | 
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: Not Enrolled in Medicare 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  |