Provider Demographics
NPI:1972802544
Name:MARTIN, SARA CONTE (RD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:CONTE
Last Name:MARTIN
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 1:2736 N HAMPDEN CT
Mailing Address - Street 2:208
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1649
Mailing Address - Country:US
Mailing Address - Phone:312-834-0653
Mailing Address - Fax:
Practice Address - Street 1:2736 N HAMPDEN CT
Practice Address - Street 2:208
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1649
Practice Address - Country:US
Practice Address - Phone:312-834-0653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal