Most Relevant Information
Provider Data
| NPI Number: | 1003074626 |
| Provider Name: | MIREYA E RENTERIA RD, LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 164.003673 |
Most Important Dates
| Enumeration Date: | 05/30/2008 |
| Last Updated: | 07/11/2012 |
Provider Practice Location
2355 S WESTERN AVE
CHICAGO
IL
606083837
Practice Location Phone/Fax
| Phone: | 7736501220 |
| Fax: | 7736501218 |
Provider Mailing Location
2355 S WESTERN AVE
CHICAGO
IL
606083837
Provider Mailing Phone/Fax
| Phone: | 7736501220 |
| Fax: |