Individual
MS. STEPHANIE RENEE MARSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
701 W NORTH AVE, MELROSE PARK, IL 60160-1699
(708) 538-4689
Mailing address
5855 N VIRGINIA AVE, CHICAGO, IL 60659-4875
(810) 923-9289
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164005394
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164005394
—
IL
Enumeration date
08/10/2011
Last updated
03/23/2022
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