Provider Demographics
NPI:1861844219
Name:CALVARIO, LINDSAY (MS, RD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:CALVARIO
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6749
Mailing Address - Country:US
Mailing Address - Phone:630-637-9300
Mailing Address - Fax:
Practice Address - Street 1:525 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6749
Practice Address - Country:US
Practice Address - Phone:630-637-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN164.004754133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered