Individual provider Active NPI

Samantha Annitza Lazar, RD

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1053012591
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2023008696 Issued in MO
Practice address
2045 W Grand Ave Ste B
PMB 37767
Chicago, IL 60612-1577
Phone
(800) 827-7437
NPI assigned
Mar 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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 2023008696 MO Primary

Addresses

Primary practice location

2045 W Grand Ave Ste B
PMB 37767
Chicago, IL 60612-1577

Mailing address

2045 W Grand Ave Ste B
Chicago, IL 60612-1577
Phone (916) 661-1400

Other names 1

  • Samantha Annitza McEnhill Former name

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
2023008696MOMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1053012591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 W GRAND AVE STE B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121577",
            "telephone_number": "916-661-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 W GRAND AVE STE B",
            "address_2": "PMB 37767",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121577",
            "telephone_number": "800-827-7437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "SAMANTHA",
        "middle_name": "ANNITZA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-13",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2023008696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "MCENHILL",
            "middle_name": "ANNITZA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.