Susannah Marie Baldock, MS, MPH, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

18N163 Hidden Hills TRL
West Dundee, IL 60118-9531

Phone

(630) 204-5773

NPI assigned

Sep 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1003423229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18N163 HIDDEN HILLS TRL",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601189531",
            "telephone_number": "630-204-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18N163 HIDDEN HILLS TRL",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601189531",
            "telephone_number": "630-204-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDOCK",
        "first_name": "SUSANNAH",
        "middle_name": "MARIE",
        "credential": "MS, MPH, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in West Dundee, IL
• Providers in West Dundee, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.