Provider Demographics
NPI:1386419380
Name:RIOS, EVELYN (RD)
Entity type:Individual
Prefix:MISS
First Name:EVELYN
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24325 S VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-5229
Mailing Address - Country:US
Mailing Address - Phone:815-582-0413
Mailing Address - Fax:
Practice Address - Street 1:839 W 79TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-2699
Practice Address - Country:US
Practice Address - Phone:815-582-0413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered