Provider Demographics
NPI:1366032989
Name:LIVI, RUTH AARON (MS, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:AARON
Last Name:LIVI
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-3455
Mailing Address - Country:US
Mailing Address - Phone:630-254-8420
Mailing Address - Fax:
Practice Address - Street 1:2407 WILLOW LN
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-3455
Practice Address - Country:US
Practice Address - Phone:630-254-8420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL86151339133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered