Provider Demographics
NPI:1235687146
Name:EYERMAN, ROSEMARY (RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:
Last Name:EYERMAN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 W LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5017
Mailing Address - Country:US
Mailing Address - Phone:773-751-4027
Mailing Address - Fax:773-907-0193
Practice Address - Street 1:4750 N SHERIDAN RD STE 379
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7511
Practice Address - Country:US
Practice Address - Phone:773-751-4027
Practice Address - Fax:773-907-0193
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164006579133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered