Provider Demographics
NPI:1508755224
Name:URRUTIA, ISABELA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ISABELA
Middle Name:
Last Name:URRUTIA
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 S MAYFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-4407
Mailing Address - Country:US
Mailing Address - Phone:708-208-6304
Mailing Address - Fax:
Practice Address - Street 1:6221 S MAYFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-4407
Practice Address - Country:US
Practice Address - Phone:708-208-6304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.011762133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered