Provider Demographics
NPI:1467900530
Name:HOWSE, DANA CHERYSE (RD/LDN)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:CHERYSE
Last Name:HOWSE
Suffix:
Gender:F
Credentials:RD/LDN
Other - Prefix:MISS
Other - First Name:DANA
Other - Middle Name:CHERYSE
Other - Last Name:MCDOUGAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD/LDN
Mailing Address - Street 1:4121 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60624-1719
Mailing Address - Country:US
Mailing Address - Phone:773-826-7066
Mailing Address - Fax:773-826-2109
Practice Address - Street 1:4121 W LAKE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-1719
Practice Address - Country:US
Practice Address - Phone:773-826-7066
Practice Address - Fax:773-826-2109
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164004230133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered