Kate Melissa Kennedy, RDN, LDN, NASM-CPT

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.005669 Issued in IL

Practice address

6596 N Ogallah Ave Apt 1B
Chicago, IL 60631-1560

Phone

(737) 936-5619

Fax

(708) 680-0124

NPI assigned

Apr 26, 2014

Reactivated

Jul 1, 2014

Last updated

Mar 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1398470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1063832269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6596 N OGALLAH AVE APT 1B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311560",
            "telephone_number": "737-936-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6596 N OGALLAH AVE APT 1B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311560",
            "telephone_number": "737-936-5619",
            "fax_number": "708-680-0124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 East Devon Avenue",
            "address_2": "Suite #309",
            "address_purpose": "LOCATION",
            "city": "Des Plaines",
            "state": "IL",
            "postal_code": "60018",
            "country_code": "US",
            "telephone_number": "847-260-5140",
            "fax_number": "224-567-8220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KATE",
        "middle_name": "MELISSA",
        "credential": "RDN, LDN, NASM-CPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-26",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "deactivation_date": "2014-06-11",
        "reactivation_date": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.005669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dejanae Kennedy
• Esther Kennedy, RD, LDN
• Jessica M. Kennedy, M.D.
• John L. Kennedy
• Kailyn Kennedy
• Kathleen Kennedy, DDS
• Kendall Kennedy, MD
• Latanya Renee Kennedy, DNP, MSN, RN,ACNS-BC
• Lofton Kennedy Jr., MD
• Marinda Carly Kennedy, MS. LPC

• Registered Dietitian in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.