Provider Demographics
NPI:1578449724
Name:OLIVEIRA, ASHLEIGH (RDN, PHD)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:OLIVEIRA
Suffix:
Gender:F
Credentials:RDN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 POND ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-6934
Mailing Address - Country:US
Mailing Address - Phone:808-280-7188
Mailing Address - Fax:
Practice Address - Street 1:2511 POND ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-6934
Practice Address - Country:US
Practice Address - Phone:808-280-7188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.022715133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered