Provider Demographics
NPI:1437946688
Name:OVERHISER, ANTHONY D (RD, LDN)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:D
Last Name:OVERHISER
Suffix:
Gender:M
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 S CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-3400
Mailing Address - Country:US
Mailing Address - Phone:312-902-2040
Mailing Address - Fax:312-648-0155
Practice Address - Street 1:10 S CLINTON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-3400
Practice Address - Country:US
Practice Address - Phone:312-902-2040
Practice Address - Fax:312-648-0155
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.010826133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered