Provider Demographics
NPI:1720109473
Name:PINTO, RENEE (CDS)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:PINTO
Suffix:
Gender:F
Credentials:CDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9930 MISSION
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-2553
Mailing Address - Country:US
Mailing Address - Phone:708-341-0320
Mailing Address - Fax:708-361-8810
Practice Address - Street 1:9930 MISSION
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-2553
Practice Address - Country:US
Practice Address - Phone:708-341-0320
Practice Address - Fax:708-361-8810
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL222Q00000X222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist