Individual
MRS. MARYSUE WITCHGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
4027 N AVERS AVE, CHICAGO, IL 60618-1901
(773) 583-8963
Mailing address
4027 N AVERS AVE, CHICAGO, IL 60618-1901
(773) 583-8963
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005489
IL
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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