Healthcare Provider Details

I. General information

NPI: 1346145406
Provider Name (Legal Business Name): DEISY N RUANO TOQUICA RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 N ASHLAND AVE APT 1
CHICAGO IL
60626-4906
US

IV. Provider business mailing address

6525 N ASHLAND AVE APT 1
CHICAGO IL
60626-4906
US

V. Phone/Fax

Practice location:
  • Phone: 312-872-2224
  • Fax:
Mailing address:
  • Phone: 312-872-2224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: