Basic Information
| Provider Information | |||||||||
| NPI: | 1043566144 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PINTO | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4320 WINFIELD RD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | WARRENVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605554023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8159426323 | ||||||||
| FaxNumber: | 8159426423 | ||||||||
| Practice Location | |||||||||
| Address1: | 4320 WINFIELD RD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | WARRENVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605554023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8159426323 | ||||||||
| FaxNumber: | 8159426423 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2012 | ||||||||
| LastUpdateDate: | 06/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TA0400X | 071007294 | IL | Y | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) |
No ID Information.