Active NPI
Nicole Conteduca
- Registered Dietitian
- Western Springs, IL
National Provider Identifier
1083124986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.006540
- Practice address
- 1152 Birch LN
Western Springs, IL 60558-2102 - Phone
- (708) 539-4586
- NPI assigned
- Oct 5, 2017
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.006540 | IL | Primary |
Addresses
Primary practice location
1152 Birch LN
Western Springs, IL 60558-2102
Mailing address
1152 Birch LN
Western Springs, IL 60558-2102
Phone (708) 539-4586
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.006540 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition Permission | Dietitian, Registered | Current | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659484800000",
"number": "1083124986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1152 BIRCH LN",
"city": "WESTERN SPRINGS",
"state": "IL",
"postal_code": "605582102",
"telephone_number": "708-539-4586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1152 BIRCH LN",
"city": "WESTERN SPRINGS",
"state": "IL",
"postal_code": "605582102",
"telephone_number": "708-539-4586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONTEDUCA",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-05",
"last_updated": "2022-08-03",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.006540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Western Springs, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.