Individual
THEODIS INGRAM JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED DIETITIAN
Contact information
Practice address
6 E MONROE ST, #603, CHICAGO, IL 60603-2704
(312) 208-1233
Mailing address
6 E MONROE ST, #603, CHICAGO, IL 60603-2704
(312) 208-1233
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.004677
IL
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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