Provider Demographics
NPI:1215464409
Name:PINTO, KARLEE ELIZABETH (RD)
Entity type:Individual
Prefix:
First Name:KARLEE
Middle Name:ELIZABETH
Last Name:PINTO
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 1:3450 N JANSSEN AVE APT A1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1269
Mailing Address - Country:US
Mailing Address - Phone:630-234-4451
Mailing Address - Fax:
Practice Address - Street 1:3523 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1137
Practice Address - Country:US
Practice Address - Phone:773-929-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL86068164133V00000X
IL164006939133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered