Samantha Mistretta, RD
Dietitian, Registered in Park Ridge, IL. Individual provider (NPI-1).
NPI number1417522012
StatusActive
Last updated in NPPESJun 24, 2021
Details
- NPI
- 1417522012
- Entity type
- Individual (NPI-1)
- Name
- Samantha Mistretta
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 25, 2021
- Certification date
- Jun 24, 2021
- Last updated
- Jun 24, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | IL | Yes |
Practice location
1775 Dempster StPark Ridge, IL 60068-1174
Phone 847-723-2210
Mailing address
3413 N Opal AveChicago, IL 60634-3046
Phone 773-559-2057
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All 29 Registered Dietitian providers in Park Ridge · All 3,132 providers in Park Ridge
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