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Individual

MS. MERLE ROSE SHAPERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,RD,CDE,LD

Contact information

Practice address
1572 MAPLE AVENUE, UNIT 604, EVANSTON, IL 60201
(708) 415-2693
(708) 763-1014
Mailing address
1572 MAPLE AVENUE, UNIT 604, EVANSTON, IL 60201
(708) 415-2693
(708) 763-1014

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.000616
IL
133V00000X
Registered Dietitian
164000616
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
164.000616
IL STATENUTRITION LICENSE
IL
Enumeration date
03/14/2007
Last updated
07/02/2014
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