NPIMap

Organization Active NPI

Summit Wellness and Nutrition PLLC

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1104637974
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
SUMMIT WELLNESS AND NUTRITION PLLC
Practice address
3354 N Racine Ave Apt a
Chicago, IL 60657-8117
Phone
(847) 436-2248
NPI assigned
Jan 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Authorized official

Name
Caitlyn N Campbell, REGISTERED DIETITIANNPI 1508492125
Title
Registered Dietitian
Phone
(847) 436-2248

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

3354 N Racine Ave Apt a
Chicago, IL 60657-8117

Mailing address

119 S Western Ave
Unit 1 Suite 230
Chicago, IL 60612
Phone (847) 436-2248

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1104637974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S WESTERN AVE",
            "address_2": "UNIT 1 SUITE 230",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "847-436-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 N RACINE AVE APT A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606578117",
            "telephone_number": "847-436-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT WELLNESS AND NUTRITION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "CAITLYN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "847-436-2248",
        "authorized_official_credential": "REGISTERED DIETITIAN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jan 20, 2025; 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.