Provider Demographics
NPI:1922238989
Name:CHENG, SIU MUI CARMAN
Entity Type:Individual
Prefix:MISS
First Name:SIU MUI
Middle Name:CARMAN
Last Name:CHENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-5018
Mailing Address - Country:US
Mailing Address - Phone:312-949-2129
Mailing Address - Fax:312-225-6324
Practice Address - Street 1:2850 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-5018
Practice Address - Country:US
Practice Address - Phone:312-949-2129
Practice Address - Fax:312-225-6324
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164004507133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic