Provider Demographics
NPI:1376867713
Name:CUTLER, EMILY RENEE (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RENEE
Last Name:CUTLER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:RENEE
Other - Last Name:CREAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LDN
Mailing Address - Street 1:1912 W BYRON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2732
Mailing Address - Country:US
Mailing Address - Phone:773-540-6423
Mailing Address - Fax:
Practice Address - Street 1:1912 W BYRON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2732
Practice Address - Country:US
Practice Address - Phone:773-540-6423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-14
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164004626133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered