Provider Demographics
NPI:1437986056
Name:PROIETTI, AME
Entity type:Individual
Prefix:
First Name:AME
Middle Name:
Last Name:PROIETTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S ELMWOOD AVE APT 23
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2975
Mailing Address - Country:US
Mailing Address - Phone:708-682-6765
Mailing Address - Fax:
Practice Address - Street 1:109 S ELMWOOD AVE APT 23
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2975
Practice Address - Country:US
Practice Address - Phone:708-682-6765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.010946133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered