Active NPI
Martha Claudia Medrano, MS RDN LDN CDCES
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1104409069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.003966
- Practice address
- 2701 W 68TH St
Chicago, IL 60629-1813 - Phone
- (773) 884-7971
- NPI assigned
- Apr 29, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 164.003966 | IL | Primary |
Addresses
Primary practice location
2701 W 68TH St
Chicago, IL 60629-1813
Mailing address
2701 W 68TH St
Chicago, IL 60629-1813
Other practice location 1
1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone (773) 275-4957
Other names 1
- Martha Claudia Salas
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.003966 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1104409069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 W 68TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606291813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 W 68TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606291813",
"telephone_number": "773-884-7971"
}
],
"practiceLocations": [
{
"address_1": "1500 S Fairfield Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606081782",
"country_code": "US",
"telephone_number": "773-275-4957",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEDRANO",
"first_name": "MARTHA",
"middle_name": "CLAUDIA",
"credential": "MS RDN LDN CDCES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-29",
"last_updated": "2021-04-29",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.003966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARTHA",
"last_name": "SALAS",
"middle_name": "CLAUDIA",
"code": "1",
"type": "Former Name"
}
]
}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 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.