Samantha Fornaris
Individual provider Active NPI Registered Dietitian · Riverside, IL
NPI 1104762137 · NPPES record last updated Apr 23, 2026
Key facts
- NPI
- 1104762137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 37 Northgate Rd
Riverside, IL 60546-1638 - Phone
- (239) 391-1860
- NPI assigned
- Apr 23, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | Yes |
Addresses
Primary practice location
37 Northgate Rd
Riverside, IL 60546-1638
Mailing address
37 Northgate Rd
Riverside, IL 60546-1638
Phone (239) 391-1860
Other providers in Riverside, IL
- Pradipkumar Shantilal Desai
- Margaret Roche Dudek
- Navos Pon Golda Durai
- Edward Tong M.D., P.C.
- Kori Feldman
- Frank R. Orland, D.D.S. & Carla P. Orland, D.D.S., LTD.
- Angela Garcia
- Kelly Garrity
- Andrea Gebhart
- Noemi Gil-Ruiz
All providers in Riverside, IL · Registered Dietitian in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.