Provider Demographics
NPI:1154114957
Name:MALDONADO, ARACELI (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:X
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 W 64TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-3729
Mailing Address - Country:US
Mailing Address - Phone:224-523-9064
Mailing Address - Fax:
Practice Address - Street 1:3521 W 64TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-3729
Practice Address - Country:US
Practice Address - Phone:224-523-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-24
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered