Amanda Wagner, M.ED, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

4631 N Lincoln Ave
Chicago, IL 60625-2007

Phone

(312) 884-9706

NPI assigned

Apr 11, 2023

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 Education

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.

• Amanda Wagner Nutrition PLLC

  • Registered Dietitian
  • Chicago, IL
  • NPI 1992550933

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1053006361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252007",
            "telephone_number": "312-884-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252007",
            "telephone_number": "312-884-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "AMANDA",
        "credential": "M.ED, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Waggoner, LCPC
• Ajay Wagh
• Taruna Waghray-Penmetcha, M.D
• Rawan Wagiealla, M.D.
• Stephanie Wagner-Lelevour, DDS
• Andrew F Wagner, MD
• Chris D Wagner, D.C.
• Elaine Janet Wagner, DC
• Ellen Swiontknowski Wagner, MD
• Emily Marie Wagner

• Registered Dietitian in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.