Individual
MRS. VIVIAN RUTH ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LDN
Contact information
Practice address
1445 W EDGEWATER AVE, CHICAGO, IL 60660-4208
(309) 660-0138
Mailing address
1445 W EDGEWATER AVE, CHICAGO, IL 60660-4208
(309) 660-0138
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164004227
IL
Other
Enumeration date
12/04/2014
Last updated
12/04/2014
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