Individual
MARIO VILLALOBOS MEDRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, RDN, LDN
Contact information
Practice address
1943 S MAY ST # 1F, CHICAGO, IL 60608-3359
(312) 549-8866
Mailing address
945 N RIDGEWAY AVE, CHICAGO, IL 60651-3838
(913) 263-4824
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164008364
IL
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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