Provider Demographics
NPI:1093340762
Name:KRSTIC, KATARINA (RD)
Entity Type:Individual
Prefix:MRS
First Name:KATARINA
Middle Name:
Last Name:KRSTIC
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 1:10115 OLD ORCHARD CT UNIT 301
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1071
Mailing Address - Country:US
Mailing Address - Phone:224-600-0053
Mailing Address - Fax:
Practice Address - Street 1:10115 OLD ORCHARD CT UNIT 301
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1071
Practice Address - Country:US
Practice Address - Phone:224-600-0053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered