Provider Demographics
NPI:1063898468
Name:TAUER, CHELSEA M (RDN, CD)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:M
Last Name:TAUER
Suffix:
Gender:F
Credentials:RDN, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:414-328-7314
Mailing Address - Fax:414-328-6210
Practice Address - Street 1:2400 S 90TH ST
Practice Address - Street 2:MOB #112
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227
Practice Address - Country:US
Practice Address - Phone:414-328-7314
Practice Address - Fax:414-328-6210
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2886-29133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered