Provider Demographics
NPI:1326319823
Name:MEADE, RACHELLE ANN (RD)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:ANN
Last Name:MEADE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2333
Mailing Address - Country:US
Mailing Address - Phone:312-922-3011
Mailing Address - Fax:312-922-5860
Practice Address - Street 1:47 W POLK ST
Practice Address - Street 2:STE G-1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2000
Practice Address - Country:US
Practice Address - Phone:312-922-3011
Practice Address - Fax:312-922-5860
Is Sole Proprietor?:No
Enumeration Date:2012-01-16
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164003021133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered