Healthcare Provider Details

I. General information

NPI: 1356197586
Provider Name (Legal Business Name): EMILY ESPOSITO MS, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2024
Certification Date: 04/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 S GROVE AVE
BARRINGTON IL
60010-5240
US

IV. Provider business mailing address

1531 S GROVE AVE
BARRINGTON IL
60010-5240
US

V. Phone/Fax

Practice location:
  • Phone: 817-205-1622
  • Fax:
Mailing address:
  • Phone: 817-205-1622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164009447
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: