Provider Demographics
NPI:1982945697
Name:JOYCE, MONICA (RD CDE)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:
Last Name:JOYCE
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 1:541 KINCAID ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5035
Mailing Address - Country:US
Mailing Address - Phone:773-636-3353
Mailing Address - Fax:
Practice Address - Street 1:9812 S DAMEN
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60043
Practice Address - Country:US
Practice Address - Phone:773-636-3353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.002111133V00000X
IL106.002111133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered