Provider Demographics
NPI:1578689808
Name:CHUPARKOFF, CRISTINA (RDN, LDN)
Entity type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:
Last Name:CHUPARKOFF
Suffix:
Gender:
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:CRISTY
Other - Middle Name:
Other - Last Name:CHUPARKOFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN, LDN, LMT
Mailing Address - Street 1:6166 SHOREWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3241
Mailing Address - Country:US
Mailing Address - Phone:815-341-4813
Mailing Address - Fax:
Practice Address - Street 1:6166 SHOREWOOD CT
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3241
Practice Address - Country:US
Practice Address - Phone:815-669-5852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227022069225700000X
IL164002844133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist