Individual
MS. LAURA MARIE SEWERYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
10400 SOUTHWEST HWY, LOWER LEVEL, CHICAGO RIDGE, IL 60415-1367
(708) 581-7308
(708) 581-7309
Mailing address
10943 MAJOR AVE, CHICAGO RIDGE, IL 60415-2410
(708) 422-6200
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164001840
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467471540
GROUP NPI
—
Enumeration date
05/09/2007
Last updated
02/29/2012
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