Individual
MS. ELENA OH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS. RDN. LDN, CDE
Contact information
Practice address
2316 PEBBLESTONE WAY, BOLINGBROOK, IL 60490-5059
(877) 443-5227
(888) 557-0978
Mailing address
2316 PEBBLESTONE WAY, BOLINGBROOK, IL 60490-5059
(401) 829-6647
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164005443
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-0466452
MULTI PLAN PROVIDER
RI
05
—
HA00033
—
RI
Enumeration date
05/11/2007
Last updated
02/20/2019
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