Anahid Edjlali, RDN

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

DI60479500 Issued in WA

Practice address

790 Remington Blvd
Bolingbrook, IL 60440

Phone

(630) 296-2223

NPI assigned

Dec 21, 2015

Sex

Female

Sole proprietor

No

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

Enrolled in WA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Daily Nutrition for Life LLC

  • Registered Dietitian
  • Bellevue, WA
  • NPI 1831600030

  WA

  Medicare reassignment NPD Authorized official
• Apple Physical Therapy, LLC

  • Physical Therapist
  • Auburn, WA
  • NPI 1902808470

  WA

  Medicare reassignment NPD
• Apple Physical Therapy LLC

  • Durable Medical Equipment & Medical Supplies
  • Mountlake Terrace, WA
  • NPI 1366746232
  NPD

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527379200000",
    "number": "1104281948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17800 TALBOT RD S STE D",
            "address_2": "STE. D",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555740",
            "telephone_number": "425-277-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "60440",
            "telephone_number": "630-296-2223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15600 NE 8th St # B1-707",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980083927",
            "country_code": "US",
            "telephone_number": "425-830-1615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDJLALI",
        "first_name": "ANAHID",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2018-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "WA",
            "license": "DI60479500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Marie Ebel
• Elizabeth Eberts
• Echelon Healthcare Services
• Senami Olubunmi Edalere Lukula
• Tony A Edeh
• Edward Health Ventures
• Edward Health Ventures
• Edward Health Ventures
• Edward Health Ventures
• Edward Hospital

• All providers in Bolingbrook, IL
• Metabolic Nutrition Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.