Provider Demographics
NPI:1902358146
Name:GRUENEWALD, HANNAH JAY (MS RD LD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:JAY
Last Name:GRUENEWALD
Suffix:
Gender:F
Credentials:MS RD LD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:SABELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 N MICHIGAN AVE STE 1900
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3994
Mailing Address - Country:US
Mailing Address - Phone:773-321-2848
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE STE 1900
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3994
Practice Address - Country:US
Practice Address - Phone:773-321-2848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-03
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004627133V00000X
IL164007647133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered