Provider Demographics
NPI:1134136237
Name:BER, LINDA SUE (RD, CDE)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUE
Last Name:BER
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 PEAR TREE LN
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5718
Mailing Address - Country:US
Mailing Address - Phone:847-520-5534
Mailing Address - Fax:847-573-4252
Practice Address - Street 1:1013 PEAR TREE LN
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5718
Practice Address - Country:US
Practice Address - Phone:847-520-5534
Practice Address - Fax:847-573-4252
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered