Provider Demographics
NPI:1962013979
Name:LOUIE, NAOMI (MPH, RDN)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:LOUIE
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5841 S. MARYLAND AVE
Mailing Address - Street 2:RM. S-414, MC 4001
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-3734
Mailing Address - Country:US
Mailing Address - Phone:773-834-6584
Mailing Address - Fax:
Practice Address - Street 1:5841 S. MARYLAND AVE
Practice Address - Street 2:RM. S-414, MC 4001
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-6063
Practice Address - Country:US
Practice Address - Phone:773-834-6584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered