Healthcare Provider Details

I. General information

NPI: 1104840560
Provider Name (Legal Business Name): HALE DENIZ-VENTURI MS, ATC, LAT, RD,LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 W VAN BUREN ST STE 425
CHICAGO IL
60612-3218
US

IV. Provider business mailing address

1700 W VAN BUREN ST STE 425
CHICAGO IL
60612-3218
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-3438
  • Fax: 312-942-5203
Mailing address:
  • Phone: 312-942-3438
  • Fax: 312-942-5203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: