Alexandra Otwell, MS, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.006655 Issued in IL

Practice address

5962 N Elston Ave
Chicago, IL 60646-5540

Phone

(773) 774-2470

NPI assigned

Oct 6, 2016

Last updated

Oct 6, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Emb Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1346290020
  NPD (past)

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1063962603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N LINCOLN PARK W APT 416",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143252",
            "telephone_number": "815-218-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5962 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465540",
            "telephone_number": "773-774-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTWELL",
        "first_name": "ALEXANDRA",
        "credential": "MS, RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.006655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Otto, M.A. CCC-SLP
• Natalie Bach Otto, MD
• Mary Otts
• Onyekachi Otugo
• Zainab Otun, RN
• Audrey Otwell
• Caitlin Otwell, MA, LCPC
• Nancy G. Otwell
• Amy Ou
• George Ou, MD

• 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 Oct 6, 2016; 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.