Doctor Name: | MRS. PUSHPA SOUNDARARAJAN |
NPI Number: | 1548638299 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, LDN, MBA |
License Number: | 164.004444 |
Business Practice Address: | 30 E 15th St Suite 201 Chicago Heights, IL - 604113459 |
Business Phone Number: | 6302901344 |
Business Fax Number: | |
Mailing Address: | 1311 S Ridge Rd, WILLOWBROOK |
State: | IL |
Postal Code: | 605271921 |
Phone Number: | 6302901344 |
Fax Number: | |
NPI Enumeration Date: | 09/11/2015 |
NPI Last Update Date: | 09/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 164.004444 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |