Individual
MS. CAREN BALTASI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDN,CCN
Contact information
Practice address
2525 WAUKEGAN RD, SUITE 255, BANNOCKBURN, IL 60015-5514
(847) 405-7611
Mailing address
2525 WAUKEGAN RD, SUITE 255, BANNOCKBURN, IL 60015-5514
(847) 405-7611
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
164.004395
IL
Other
Enumeration date
09/21/2007
Last updated
04/23/2010
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