Healthcare Provider Details

I. General information

NPI: 1073424719
Provider Name (Legal Business Name): CAROLINE KUENSTER RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 W EDDY ST APT 2
CHICAGO IL
60657-1493
US

IV. Provider business mailing address

1315 W EDDY ST APT 2
CHICAGO IL
60657-1493
US

V. Phone/Fax

Practice location:
  • Phone: 651-666-8273
  • Fax:
Mailing address:
  • Phone: 651-666-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT93168
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164.022537
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: