Provider Demographics
NPI:1538489265
Name:SOULE, OEHME (RD)
Entity Type:Individual
Prefix:
First Name:OEHME
Middle Name:
Last Name:SOULE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:C. OEHME
Other - Middle Name:
Other - Last Name:SOULE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:1609 SHERMAN AVE
Mailing Address - Street 2:SUITE 326
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3753
Mailing Address - Country:US
Mailing Address - Phone:847-328-1085
Mailing Address - Fax:847-475-2535
Practice Address - Street 1:1609 SHERMAN AVE
Practice Address - Street 2:SUITE 326
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3753
Practice Address - Country:US
Practice Address - Phone:847-328-1085
Practice Address - Fax:847-475-2535
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164003118133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered