Marie, Vickie

Marie, Vickie is an sole proprietor health care provider with primary practice located at 10553 S Calumet Ave , Chicago IL 60628-2836. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Marie, Vickie can be contacted via phone (773) 264-2687.

Contact Information

Primary practice address
10553 S Calumet Ave Chicago IL 60628-2836
Phone: (773) 264-2687
Fax: (773) 264-2687
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 164003006 Illinois
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 37001171A Indiana

Profile Details

NPI number 1841337086
LBN Legal business name Marie, Vickie
Credentials MA, RD, LDN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2007
Last updated Dec 29th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841337086 NPPES
Illinois Other 0001633301 BLUE CROSS BLUE SHIELD

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