Active NPI
Janet Fraker, L.D.N.
- Nutritionist
- Rockford, IL
National Provider Identifier
1053683524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 164-0008000
- Practice address
- 1601 N University Dr
Rockford, IL 61107-5317 - Phone
- (815) 387-2500
- Fax
- (815) 387-2590
- NPI assigned
- Jan 31, 2012
- Last updated
- Jan 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 164-0008000 | IL | Primary |
Addresses
Primary practice location
1601 N University Dr
Rockford, IL 61107-5317
Mailing address
11927 Lanark CT
Caledonia, IL 61011-9794
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
| License | State | Type | Specialty |
|---|---|---|---|
| 164-0008000 | IL | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327968000000",
"number": "1053683524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11927 LANARK CT",
"city": "CALEDONIA",
"state": "IL",
"postal_code": "610119794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 N UNIVERSITY DR",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611075317",
"telephone_number": "815-387-2500",
"fax_number": "815-387-2590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAKER",
"first_name": "JANET",
"credential": "L.D.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-31",
"last_updated": "2012-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "IL",
"license": "164-0008000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.