Individual
REGINA E. SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED DIETITIAN
Contact information
Practice address
1531 S SAINT LOUIS AVE, CHICAGO, IL 60623-2155
(773) 521-4665
Mailing address
1531 S SAINT LOUIS AVE, CHICAGO, IL 60623-2155
(773) 521-4665
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
IL
Other
Enumeration date
06/11/2007
Last updated
07/08/2007
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