Provider Demographics
NPI:1861905812
Name:EKELMAN, MARGARITA (MBA, RDN, LDN)
Entity type:Individual
Prefix:MRS
First Name:MARGARITA
Middle Name:
Last Name:EKELMAN
Suffix:
Gender:F
Credentials:MBA, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6870 ELLIS DR
Mailing Address - Street 2:
Mailing Address - City:LONG GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60047-5107
Mailing Address - Country:US
Mailing Address - Phone:847-409-5436
Mailing Address - Fax:
Practice Address - Street 1:6870 ELLIS DR
Practice Address - Street 2:
Practice Address - City:LONG GROVE
Practice Address - State:IL
Practice Address - Zip Code:60047-5107
Practice Address - Country:US
Practice Address - Phone:847-409-5436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-13
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
IL164.00607133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered