Healthcare Provider Details

I. General information

NPI: 1528650736
Provider Name (Legal Business Name): STEPHANIE NICHOLE QUINT MS, RD, LDN, CHES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE NICHOLE ALLISON MS, RD, LDN, CHES

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 W DIVISION ST
CHICAGO IL
60622-3939
US

IV. Provider business mailing address

202 W FOX HILL DR
BUFFALO GROVE IL
60089-7706
US

V. Phone/Fax

Practice location:
  • Phone: 855-552-5557
  • Fax:
Mailing address:
  • Phone: 847-668-1639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number10239769
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND13102
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164.007172
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number108680
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3240
License Number StateWI
# 6
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2014
License Number StateWV
# 7
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX8525
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: