Provider Demographics
NPI:1194504563
Name:ARCEO, CRISTINA (MS RDN LDN IBCLC)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:ARCEO
Suffix:
Gender:F
Credentials:MS RDN LDN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2417
Mailing Address - Country:US
Mailing Address - Phone:312-380-5344
Mailing Address - Fax:312-277-0932
Practice Address - Street 1:3921 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2417
Practice Address - Country:US
Practice Address - Phone:312-380-5344
Practice Address - Fax:312-277-0932
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL-130020174N00000X
IL164.005977133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN