Provider Demographics
NPI:1063037224
Name:MORALES-PEREZ, MELISSA (RDN)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:MORALES-PEREZ
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 W DEVON AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-2097
Mailing Address - Country:US
Mailing Address - Phone:708-925-2192
Mailing Address - Fax:
Practice Address - Street 1:6440 W DEVON AVE APT 203
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-2097
Practice Address - Country:US
Practice Address - Phone:708-925-2192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered