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Individual

MRS. PUSHPA SOUNDARARAJAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, LDN, MBA

Contact information

Practice address
30 E 15TH ST, SUITE 201, CHICAGO HEIGHTS, IL 60411-3459
(630) 290-1344
Mailing address
1311 S RIDGE RD, WILLOWBROOK, IL 60527-1921
(630) 290-1344

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.004444
IL

Other

Enumeration date
09/11/2015
Last updated
09/11/2015
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