Provider Demographics
NPI:1104584937
Name:PRESBREY, EMILY VICTORIA (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:VICTORIA
Last Name:PRESBREY
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6S546 DENSMORE RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-8913
Mailing Address - Country:US
Mailing Address - Phone:847-452-8759
Mailing Address - Fax:
Practice Address - Street 1:535 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6795
Practice Address - Country:US
Practice Address - Phone:331-305-3998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.007070133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty