Provider Demographics
NPI:1659257293
Name:HUNGERFORD, KYRA (RDN)
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:
Last Name:HUNGERFORD
Suffix:
Gender:X
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 W MONROE ST UNIT 314A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2477
Mailing Address - Country:US
Mailing Address - Phone:641-750-9427
Mailing Address - Fax:
Practice Address - Street 1:1515 W MONROE ST # A314
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1547
Practice Address - Country:US
Practice Address - Phone:641-750-9427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.012335133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered