Alexa Eberhard, CCN, LDN

Primary specialty

NutritionistTaxonomy code 133N00000X

License

164.006837 Issued in IL

Practice address

17023 Harlem Ave
Tinley Park, IL 60477-2739

Phone

(708) 614-1222

NPI assigned

Apr 27, 2018

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

State licenses

Practice roles

Locations

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.

• Beyer Chiropractic Clinic SC

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  • NPI 1811090491
  NPD
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  • Chiropractor
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  • NPI 1699428565
  NPD

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1043708795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17023 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772739",
            "telephone_number": "708-614-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17023 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772739",
            "telephone_number": "708-614-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHARD",
        "first_name": "ALEXA",
        "credential": "CCN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164.006837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Tinley Park, IL
• Nutritionist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.