Individual
NEDA KHUDEIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8071 S CICERO AVE, CHICAGO, IL 60652-2003
(773) 585-0480
(773) 585-0482
Mailing address
9405 S OKETO AVE, BRIDGEVIEW, IL 60455-2140
(773) 585-0480
(773) 585-0482
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
164.007233
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164.007233
LICENSED DIETITAN NUTRITIONIST
IL
Enumeration date
01/30/2018
Last updated
01/30/2018
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