Healthcare Provider Details

I. General information

NPI: 1053417097
Provider Name (Legal Business Name): LISA A PINTO PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1288 RICKERT DR SUITE 300
NAPERVILLE IL
60540-0951
US

IV. Provider business mailing address

PO BOX 387
ADDISON IL
60101-0387
US

V. Phone/Fax

Practice location:
  • Phone: 630-416-6056
  • Fax:
Mailing address:
  • Phone: 630-258-3492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071004338
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: