Individual provider Active NPI

Brenda Beben, RD

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1063918555
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
45 W 111TH St
Chicago, IL 60628-4200
Phone
(773) 995-3234
NPI assigned
Apr 3, 2018
Last updated
Apr 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary
Pediatric Nutrition Registered Dietitian 133VN1004X NU
Renal Nutrition Registered Dietitian 133VN1005X NU
Metabolic Nutrition Registered Dietitian 133VN1006X NU

Addresses

Primary practice location

45 W 111TH St
Chicago, IL 60628-4200

Mailing address

5330 Forest TRL
Oak Forest, IL 60452-4400
Phone (630) 768-4942

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

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1063918555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 FOREST TRL",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604524400",
            "telephone_number": "630-768-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284200",
            "telephone_number": "773-995-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEBEN",
        "first_name": "BRENDA",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Apr 3, 2018; 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.