Active NPI
Richard Lane Logan, RD
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1063189132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164008466
- Practice address
- 2800 N Milwaukee Ave Apt 504
Chicago, IL 60618-7984 - Phone
- (317) 364-2202
- NPI assigned
- Aug 26, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164008466 | IL | Primary |
Addresses
Primary practice location
2800 N Milwaukee Ave Apt 504
Chicago, IL 60618-7984
Mailing address
2800 N Milwaukee Ave Apt 504
Chicago, IL 60618-7984
Phone (317) 364-2202
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164008466 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Live Limitless Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779926400000",
"number": "1063189132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 N MILWAUKEE AVE APT 504",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606187984",
"telephone_number": "317-364-2202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 N MILWAUKEE AVE APT 504",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606187984",
"telephone_number": "317-364-2202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "RICHARD",
"middle_name": "LANE",
"name_prefix": "Mr.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-26",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164008466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 May 28, 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.