Healthcare Provider Details

I. General information

NPI: 1639798242
Provider Name (Legal Business Name): ERIKA JOY MEIER MPH, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 04/14/2020
Certification Date: 04/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 S PROMONTORY DR
CHICAGO IL
60649-1002
US

IV. Provider business mailing address

6501 S PROMONTORY DR
CHICAGO IL
60649-1002
US

V. Phone/Fax

Practice location:
  • Phone: 773-256-5948
  • Fax: 773-363-7143
Mailing address:
  • Phone: 773-256-5948
  • Fax: 773-363-7143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164007469
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: