Provider Demographics
NPI:1255186227
Name:SUHAYDA, STEPHEN (MS, RDN)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:SUHAYDA
Suffix:
Gender:M
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1847 S WENTWORTH CIR
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-5102
Mailing Address - Country:US
Mailing Address - Phone:630-689-1797
Mailing Address - Fax:
Practice Address - Street 1:1847 S WENTWORTH CIR
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-5102
Practice Address - Country:US
Practice Address - Phone:630-689-1797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered