Individual provider Active NPI

Deanna Marie Cancello, RDN

  • Registered Dietitian
  • Glenview, IL
National Provider Identifier
1003401811
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86098532 Issued in IL
Practice address
2420 Ravine Way Ste 400
Glenview, IL 60025-7651
Phone
(647) 686-4444
NPI assigned
Mar 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86098532 IL Primary

Addresses

Primary practice location

2420 Ravine Way Ste 400
Glenview, IL 60025-7651

Mailing address

2420 Ravine Way Ste 400
Glenview, IL 60025-7651
Phone (647) 686-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
86098532ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Heal N Cure CurrentSince Mar 7, 2021 Accepting new patients

Locations

2420 Ravine Way
Ste 400
Glenview, IL 60025
Phone (847) 657-9877

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1003401811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 RAVINE WAY STE 400",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257651",
            "telephone_number": "647-686-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 RAVINE WAY STE 400",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257651",
            "telephone_number": "647-686-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCELLO",
        "first_name": "DEANNA",
        "middle_name": "MARIE",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "86098532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.