Individual provider Active NPI

Susan Kagen Podell, MS

  • Metabolic Nutrition Registered Dietitian
  • Mundelein, IL
National Provider Identifier
1053456384
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
Practice address
560 N Midlothian Rd
Suite 400
Mundelein, IL 60060-1654
Phone
(847) 837-8442
Fax
(847) 837-8542
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X IL Primary

Addresses

Primary practice location

560 N Midlothian Rd
Suite 400
Mundelein, IL 60060-1654

Mailing address

560 N Midlothian Rd
Suite 400
Mundelein, IL 60060-1654
Phone (847) 837-8442

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)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation PastSince Jul 7, 2008 Accepting new patients

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053456384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 N MIDLOTHIAN RD",
            "address_2": "SUITE 400",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601654",
            "telephone_number": "847-837-8442",
            "fax_number": "847-837-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 N MIDLOTHIAN RD",
            "address_2": "SUITE 400",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601654",
            "telephone_number": "847-837-8442",
            "fax_number": "847-837-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODELL",
        "first_name": "SUSAN",
        "middle_name": "KAGEN",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mundelein, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.