Provider Demographics
NPI:1043566144
Name:PINTO, SUZANNE M (PSYD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:PINTO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 WINFIELD RD
Mailing Address - Street 2:STE 200
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-4023
Mailing Address - Country:US
Mailing Address - Phone:815-942-6323
Mailing Address - Fax:815-942-6423
Practice Address - Street 1:4320 WINFIELD RD
Practice Address - Street 2:STE 200
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-4023
Practice Address - Country:US
Practice Address - Phone:815-942-6323
Practice Address - Fax:815-942-6423
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2019-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007294103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)