Provider Demographics
NPI:1760284608
Name:CAPUTO, THERESA ANN (MS, RDN, LDN, CCTD)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:ANN
Last Name:CAPUTO
Suffix:
Gender:
Credentials:MS, RDN, LDN, CCTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 BENDING CT
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-8710
Mailing Address - Country:US
Mailing Address - Phone:847-207-3260
Mailing Address - Fax:
Practice Address - Street 1:671 BENDING CT
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-8710
Practice Address - Country:US
Practice Address - Phone:847-207-3260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164008121133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered