Provider Demographics
NPI:1518447796
Name:DOSHI, CHRISTINE ELYSE (RD, LD, MS, CSOWM)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELYSE
Last Name:DOSHI
Suffix:
Gender:F
Credentials:RD, LD, MS, CSOWM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 PLANTATION CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5674
Mailing Address - Country:US
Mailing Address - Phone:734-845-6856
Mailing Address - Fax:
Practice Address - Street 1:1331 W 75TH ST STE 201
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-9311
Practice Address - Country:US
Practice Address - Phone:630-527-7205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1032606133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered