Provider Demographics
NPI:1992221758
Name:RITZEMA, ROSALIA MARIE (MS, RDN, LDN, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:ROSALIA
Middle Name:MARIE
Last Name:RITZEMA
Suffix:
Gender:F
Credentials:MS, RDN, LDN, CDCES
Other - Prefix:MS
Other - First Name:ROSALIA
Other - Middle Name:MARIE
Other - Last Name:NUNEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:326 MASHPEE LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-4259
Mailing Address - Country:US
Mailing Address - Phone:847-736-0107
Mailing Address - Fax:
Practice Address - Street 1:7435 W TALCOTT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3707
Practice Address - Country:US
Practice Address - Phone:773-990-5164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL86088830133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered