Active NPI
Shuefen C Dimarco, MPH, RD, CSP, CNSD
- Pediatric Nutrition Registered Dietitian
- Naperville, IL
National Provider Identifier
1063664308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- License
- 164.001121
- Practice address
- 675 Wintergreen Cir
Naperville, IL 60540-9202 - Phone
- (630) 361-3674
- Fax
- (630) 357-8412
- NPI assigned
- Oct 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 164.001121 | IL | Primary |
Addresses
Primary practice location
675 Wintergreen Cir
Naperville, IL 60540-9202
Mailing address
675 Wintergreen Cir
Naperville, IL 60540-9202
Phone (630) 361-3674
Other names 1
- Mrs. Florence Chien Dimarco
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.001121 | IL | MD | Pediatric Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dimarco Nutrition in Action | Nutrition, Pediatric | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Nutrition Registered Dietitian
- Naperville, IL
- NPI 1235256181
Nutrition, Pediatric
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224201600000",
"number": "1063664308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "675 WINTERGREEN CIR",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605409202",
"telephone_number": "630-361-3674",
"fax_number": "630-357-8412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 WINTERGREEN CIR",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605409202",
"telephone_number": "630-361-3674",
"fax_number": "630-357-8412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMARCO",
"first_name": "SHUEFEN",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "MPH, RD, CSP, CNSD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-17",
"last_updated": "2008-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "IL",
"license": "164.001121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "FLORENCE",
"last_name": "DIMARCO",
"middle_name": "CHIEN",
"prefix": "MRS.",
"credential": "MPH, RD, CSP, CNSD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.