Provider Demographics
NPI:1932593217
Name:VALENTINO, KATIE N
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:N
Last Name:VALENTINO
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 1:13021 ROLLING MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-4574
Mailing Address - Country:US
Mailing Address - Phone:630-244-8783
Mailing Address - Fax:
Practice Address - Street 1:2835 SHOWPLACE DR STE 119
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5056
Practice Address - Country:US
Practice Address - Phone:630-470-4878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277001165363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL277001165OtherSTATE OF ILLINOIS APN LICENSE
IL041384467OtherSTATE OF ILLINOIS RN LICENSE